14,861 hospitalizations for Dupuytren's surgeries (fasciectomies) in 2001. How many got NA in France that year?

J Hand Surg [Br]. 2005 Oct;30(5):484-7.

Dupuytren's Disease in France - 1831 to 2001 - from Description to Economic Burden.

Maravic M, Landais P.
From the Hopital Necker Enfants Malades (APHP), Service de Biostatistique et Informatique Medicale, Paris Cedex, France.

We recorded all elective admissions for Dupuytren's disease from the French National Hospital Database. We used the data from first hospitalizations to calculate the 2001 hospitalization rates for this condition and determine geographical differences between different regions of France. We also calculated the hospital costs of treating admissions with this disease. Fourteen thousand eight hundred and sixty hospitalizations for Dupuytren's disease were reported in France in 2001, of which 93% were for a first treatment. The disease was mostly present in men and was mostly managed by surgical fasciectomy. Most operations were carried out in private hospitals, with a mean stay of 2 days. Geographical differences were found in men only. The total hospital cost for all elective admissions was 14, 179, 998 Euros, indicating the considerable financial burden to the State of treating this condition.

PMID: 15993524 [PubMed - in process]

Randy said: "When a general practitioner sees a Dups case, he ships the patient off to his favorite CHS." This has been correct in my case. My general practitioner has shown interest in NA after he saw the results of Dr. Eaton's work on my pinky. At his request, I sent him the list of NA practitioners that I posted in this forum. Perhaps it is the general practitioners we need to convince. They are much more receptive. They could refer NA cases to the nearest NA practitioner. In my case that would be Dr. Denkler.

All MDs - GPs and surgeons - are increasingly just employees of clinics, HMOs and other corporate entities where they're told to refer patients to other "network providers" whenever possible. Add a little profit-sharing and other incentives to the mix and you have a nicely self-perpetuating system for confining patients to the options your company can currently provide.

When I talked to my GP about DC he just automatically gave me the name of the hand surgeon in their network and assumed that would be my next stop.

These guys may all think they're doing the right thing in some sense but it's a system that's highly resistant to change from below. And seen from the top, why jump at the chance to replace an expensive procedure with a cheap one?


Combining the GPs and the surgeons in one business creates one big conveyor belt to surgery. That's part of the reason so many unnecessary surgeries are done in this country.