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suggestive evidence that doctors do unnecessary stent procedures to enrich themselves
Old 12-31-2018, 05:51 AM   #1
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suggestive evidence that doctors do unnecessary stent procedures to enrich themselves

I was reading an article yesterday in the latest issue (Dec 31, 2018) of Barron's magazine. It is about a study and a Dec 17 report in the Journal of American Medical Association-Internal Medicine "JAMA" finding suggestive evidence that doctors misdiagnose patients to enrich themselves.

“ The JAMA study counted the stenting procedures in outpatient facilities on patients diagnosed with unstable angina.” “ ...unstable angina usually means that a person is having a heart attack, meaning that there shouldn't be many outpatient procedures for this acute condition. A doctor typically should rush such a patient to the emergency room, not schedule them for an elective procedure, the study said.”

"In Florida, the number of outpatient procedures for such acute diagnoses increased by some 50% from 2010 to 2014. in Michigan, the increase was threefold. In New York, tenfold."


“After large-scale clinical trials failed to show stenting reduced the risk of heart attack or death in patients with stable angina, the recommended treatment became medicine and stress-monitoring. New York's Medicaid program started refusing payment for inappropriate stenting. That was around the time that New York diagnoses for acute conditions like unstable angina started to rise, from 0.6% of outpatient procedures in 2010 to 8% in 2014, according to the recent JAMA study.”
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Old 12-31-2018, 07:08 AM   #2
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I fail to see "... to enrich themselves" evidence in your quotes. There are alternate explanations:

1. The only codes currently available to doctors are basically "stable, just watch them", and "OMG they're dying". There is a large gray area between these two, where warning signs are starting to appear, and docs may rather be safe than sorry.

2. Medical malpractice, anyone? Docs may be scared of surviving family suing them because they "knew something was wrong" and yet did nothing.

3. From what I've heard, a lot of docs view death as The Enemy, and will take extra precautions (like stenting) in order to prevent a heart attack later. The ease of these procedures also encourages them to view the risk/benefit ratio differently than, say, open heart surgery.

Let's not paint all doctors with a broad brush. They're people too, and I dare you to provide evidence that they're actually less ethical than average.
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Old 12-31-2018, 10:18 AM   #3
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[QUOTE=Maenad;2165153]I fail to see "... to enrich themselves" evidence in your quotes.


No but the word "suggestive" coveres that.

There are alternate explanations:

There almost always are. Which brings us to.....


Quote:
2. Medical malpractice, anyone? Docs may be scared of surviving family suing them because they "knew something was wrong" and yet did nothing.
They will always sling alternate realities. I just went thru this with family. It is like saying "poor farmers". In every state it is nearly impossible to get a doctor on the hook for almost anything. It ain't malpractice they're afraid of.

Quote:
Let's not paint all doctors with a broad brush.
That much is true

Quote:
They're people too, and I dare you to provide evidence that they're actually less ethical than average.
No hard evidence is needed or can be provided and if it were it wouldn't apply to any individual doctors. Just look at what they have at state. How much control they have and how much they can get away with and without consequences. That tells you a lot about how wary a person needs to be of any group. That's why so many people don't like government. It applies to loots of others not in government too. What are they convinced they can get away with. Red Flag.

I see no reason to believe doctors are or even could be any more ethical or honest than any other group. If cops plant evidence. If teachers have a favorite student. If lawyers write laws to favor lawyers. If clergy can be believed for thousands of years just because they are clergy and they all know they will get away with it. I see no reason to think doctors are playing any other game.
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Old 12-31-2018, 10:31 AM   #4
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Originally Posted by DEC-1982 View Post
I was reading an article yesterday in the latest issue (Dec 31, 2018) of Barron's magazine. It is about a study and a Dec 17 report in the Journal of American Medical Association-Internal Medicine "JAMA" finding suggestive evidence that doctors misdiagnose patients to enrich themselves.

“ The JAMA study counted the stenting procedures in outpatient facilities on patients diagnosed with unstable angina.” “ ...unstable angina usually means that a person is having a heart attack, meaning that there shouldn't be many outpatient procedures for this acute condition. A doctor typically should rush such a patient to the emergency room, not schedule them for an elective procedure, the study said.”

"In Florida, the number of outpatient procedures for such acute diagnoses increased by some 50% from 2010 to 2014. in Michigan, the increase was threefold. In New York, tenfold."


“After large-scale clinical trials failed to show stenting reduced the risk of heart attack or death in patients with stable angina, the recommended treatment became medicine and stress-monitoring. New York's Medicaid program started refusing payment for inappropriate stenting. That was around the time that New York diagnoses for acute conditions like unstable angina started to rise, from 0.6% of outpatient procedures in 2010 to 8% in 2014, according to the recent JAMA study.”
JAMA said doctors do this to make more money or is that just your humble opinion? That's why they track these things long term the stents don't help everyone but they do help some, so maybe the guidelines will change.

After an open heart procedure a few year ago my DH had a 8 second episode of torsades or heart quiver caught by his hospital monitor. He came out of it on his own. Two days later after more tests and a review of family history he got a defibrillator installed.

We had a tech who had been working with Defib units for many years and she many people died because the old standard of care was you needed to have two episodes of trouble before you could get a defib and many people died while "proving" they needed one.

He's using a nationally ranked heart clinic for his care and from what I've seen in the last 6 years they wish they had less to do not more. There aren't enough hours in the day for them to get everything done.
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Old 12-31-2018, 10:56 AM   #5
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I'm stunned. Nay, aghast.

Of course they do. Not all, but some.

It helps that extra tests also protect against malpractice suits, so there's a double incentive. If you work for a hospital, it also helps your employer think highly of you, since you generate lots of money for the hospital. Triple incentive.
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Old 12-31-2018, 11:07 AM   #6
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I'm stunned. Nay, aghast.

Of course they do. Not all, but some.

It helps that extra tests also protect against malpractice suits, so there's a double incentive. If you work for a hospital, it also helps your employer think highly of you, since you generate lots of money for the hospital. Triple incentive.
Some are just idiots too. Been dizzy for a long time, my PCP referred me to a cardiologist. He was surprised but found a couple test to run and then passed me to an ENT, who had a name and treatment for my condition.
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Old 01-01-2019, 08:05 AM   #7
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It is NOT an open-and-shut case but it's POSSIBLY one of many reasons American health costs are out of control.
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Old 01-01-2019, 11:56 AM   #8
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It isn't always the doctors trying to line their pockets, often times it's the corporation/hospital that employs the doctors that puts pressure on the staff to maximize income. It was some time ago so don't recall all the details but '60 Minutes' did a report about hospitals that would track emergency room stats like the percentage of patients in the ER that were admitted overnight. The ER doctors were expected to meet or exceed a certain percentage. Seemed to have little to do if the illness or reason for going to the ER actually required an overnight stay. Not all doctors were happy about this and their complaints were one of the reasons the story came out.
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