Originally Posted by LuckyR
Human nature is also obvious and there are many incentives in a Fee for Service world to connect the dots in a patient sitting in your office with symptoms and an abnormal scan to perform a highly compensated procedure like back surgery, even if the findings of the scan are moderately abnormal (not severely so). Perhaps you missed the word: "substantial" in the citation.
And yes these findings are "long known", since the first studies are from the early 90's.
That's why many doctors will not order scans unless the symptoms were severe enough (i.e.. extreme loss of strength in a leg, paralysis, etc). And, it's widely accepted among physicians that scans will lead to false findings that are not causing any problems.
If a physician opts for surgery, it's because he's a orthopedic surgeon who believes surgery is the best solution. Perhaps there are few doctors who lick their chops and think "Yeah, surgery, more money." but it rarely works out like that.