A class action lawsuit has been filed against Renton, Washington-based Providence Health & Services Washington, Jason Dreyer, D.O., and Daniel Elskens, M.D. in the Superior Court of King County.
Lawsuit Alleges Neurosurgeons Performed Unnecessary Procedures
Providence runs 51 hospitals across seven states, including Providence St. Mary’s Medical Center. Providence St. Mary’s is where Dr. Dreyer and Dr. Elskens were both once employed as neurosurgeons.
The plaintiffs, also former patients, are alleging that the doctors performed unnecessary procedures including spinal fusions. As a result of these allegedly unnecessary procedures, the former patients are claiming that they suffered permanent damage.
One patient claims that she sought treatment for lower back pain and instead, per the physician’s recommendation, underwent neck surgery. She asserts that the neck surgery damaged her vocal cords. She also claims that a subsequent surgery caused further damage.
Another patient asserts that he similarly sought treatment for lower back pain and instead, per the physician’s recommendation, underwent neck surgery. He claims that as a result of that surgery he was no longer able to work. He also claims that a subsequent surgery resulted in him having permanent nerve damage.
Neither neurosurgeon is still employed by Providence. One neurosurgeon left in 2017 and the other left in 2018.
The lawsuit comes on the heels of a recent settlement involving Providence Health & Services Washington and two unnamed neurosurgeons. According to the Department of Justice press release, Providence Health & Services Washington “agreed to pay $22,690,458 to resolve allegations that it fraudulently billed Medicare, Medicaid, and other federal health care programs for medically unnecessary neurosurgery procedures.” The settlement represents the “largest-ever health care fraud settlement in the Eastern District of Washington.”
According to the settlement, Providence St. Mary’s paid neurosurgeons based on a personal productivity metric. Per the settlement agreement, “the greater the number of procedures of higher complexity that the neurosurgeon performed, the greater the compensation the neurosurgeon received.” Based on this pay structure, between 2014 and 2017, one of the neurosurgeons earned between $2.5 million and $2.9 million each year.

Discussion
This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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