Don’t be afraid to ask your doctor before starting any expensive, extensive or intrusive treatment whether it is really necessary or worthwhile under a risk/benefit analysis. Many expensive procedures are not only risky but often do not result in improvement. For example, spine surgery comes with the risk of infections, paralysis, and loss of flexibility. A study in the Annals of Internal Medicine compared the outcomes of patients who underwent lumbar spine surgery with those who only did physical therapy. Two years later the study found no difference in pain or physical function between the two groups. Plus, about a fourth of the patients in the surgery group suffered complications, such as infections or repeat surgery , while only about ten per cent of the physical therapy group felt worsening symptoms. Remember when taking advice from surgeons that they only get paid when they operate. Similarly, if your doctor recommends a brand name drug, ask if there is a generic drug with the same chemical makeup for a much lower price.