Let the Buyer Beware. Seriously?

Once again an American city is shocked by allegations that a trusted local doctor has been performing unnecessary medical procedures in order to line his pockets.  We saw this movie just a few months ago when a Detroit cancer doctor was convicted and sentenced for treating people for years for cancers they did not have.  In this latest version, which is situated in an Indiana town about 30 miles outside Chicago, a cardiologist has been sued for medical malpractice by 293 patients who each claim that he and two partners performed procedures on them which were medically unnecessary and for which the doctors received large payments from insurers and Medicare.  The evidence appears to be pretty strong that many of the operations this cardiologist performed were not needed.

The doctor and his two partners received nearly $5,000,000.00 in combined Medicare payments in 2013, which made them the most highly reimbursed cardiologists in the entire state of Indiana.  They certainly received still more money from private insurers but that information is not available in the public record as the Medicare information is.  When the data for placement of cardiac defibrillators was examined by a team from a respected university, it showed that the area had some of the highest rates of defibrillator placement in the country, even after adjusting for age, sex and race.  The area’s rates of angioplasties and cardiac catheterizations were among the highest in the state.  All of these procedures were performed by the cardiologist and his partners.

The former president of the American College of Cardiology has been quoted as stating that the fee-for-service system used widely in American medicine has the obvious potential for tempting some doctors to do procedures which are not necessary just so that they can keep the income stream flowing to themselves.  He also observed that cardiac procedures are big moneymakers for hospitals and that this fact sometimes causes hospitals to look the other way so that they keep their income stream flowing as well.  Many of the patients suing the cardiologists are also suing the hospital at which they performed the procedures.

At the end of the excellent New York Times story on this sad state of affairs, one of the patients who had what is claimed to have been an unnecessary operation laments that she just trusted her doctor.  Next time she says, she is going to get a second opinion.  Don’t you wait to be the victim of medical malpractice before you decide that it is a good idea to get a second opinion.

Posted in Doctors, Fee for Service, Hospitals, Lawsuits, Medical Malpractice, medical malpractice cases, Medicare |