Is elective spinal surgery overused in private health care in Australia?

When approached some years ago to join a multicentre randomised controlled trial of decompression for people with spinal canal stenosis, I said I couldn't possibly do this, as I firmly believed it was a good treatment in the right circumstances. However, I now had a slow growing worm in my brain. Was this in response to my own cognitive dissonance, or the subliminal effect of scepticism about the benefits of much surgery?1 No doubt I was also influenced by the number of older people I was seeing in my clinic (I have just successfully undertaken a laminectomy in a woman of quite advanced age) and the delays caused by the COVID‐19 pandemic (I have just seen a teenager with scoliosis who had been referred to me in 2021).