In today's Baltimore Sun, reporter Tricia Bishop looks at the use of stents and the risks they bring. According to the article, until recently, use of cardiac stents to open blocked arteries has been all the rage and was seen as a relatively safe procedure when compared to open heart coronary bypass surgery. Since the 1990s, stents have been increasingly used and have generated more than $1 billion of revenue for Maryland's hospitals.
In the wake of close to 600 claims against Mark Midei, M.D.- the once preeminent interventional cardiologist at St. Joseph's Medical Center in Towson, Maryland -- for unnecessary stenting of patients with little or no artery blockage, the health care community is now taking a hard look at the risks and benefits of cardiac stents and is now trending away from using them in favor of medications or bypass surgery. According to statistics from the state Health Services Cost Review Commission, stenting procedures in Maryland will drop by 25% this year (from 14,255 to 10,650).
Some of the comments and opinions expressed by those interviewed are rather remarkable. Most striking are the comments of Dr. William O'Neill, executive dean of clinical affairs at the University of Miami's Miller School of Medicine. Dr. O'Neill, who was hired by St. Joe's to review Dr. Midei's patient charts, claims that he found "no unwarranted stents."
With all due respect to Dr. O'Neill, our firm and many others have hired top flight interventional cardiologists to review Dr. Midei's charts and in many instances, there was absolutely no blockages whatsoever. Many patients' own cardiologists have also reviewed Dr. Midei's films and reports and cannot reconcile the reported findings against the films. The referring cardiologists have reviewed the data at the request of their patients who received the now well known yet cryptic letter from St. Joe's warning patients to consult with their physicians about possible harm. In more than a few cases, patients report that the treating doctors have simply shrugged their shoulders in dismay and have offered apologies for referring them to Dr. Midei.
Dr. O'Neill is also quoted as suggesting that physicians who perform stenting on borderline patients, i.e., those with close to 70% blockage, will now "be afraid that some angry patient or angry attorney or disgruntled colleague or competitor is going to turn him in for doing unnecessary procedures." Once again, when the goings get tough, the defensive medicine argument rears its ugly head. Dr. O'Neill further justifies unnecessary stenting by stating that "[f]or some of these doctors, it was like, 'I'm here, so let me go ahead and put a stent in.'"
One must wonder whether Dr. O'Neill intends to offer the same opinions in court as he has in today's article in the Baltimore Sun.
At least four studies over the last four years have found that stenting generally is not without some significant risks, even with the most recent development of the drug-alluding stent that was hailed a few years ago by Dr. Midei as the "hottest thing in cardiology in years."
The Baltimore Sun should be commended for its ongoing effort to bring to light the continuing issues related to the actions and possible harm caused by Dr. Midei. Many in the community are understandably perplexed and disappointed that a physician could invade his patients' rights and expose them to such unnecessary risks. Dr. Midei has many supporters, but he has many injured and very concerned patients as well.
Belsky, Weinberg & Horowitz continues to represent patients in medical malpractice cases, including those who have received stents unnecessarily. Please contact the firm for more information.
Why has America spent hundreds of billions on the treatment of heart disease symptoms and not the prevention?
What is causing the inflammation and the hypertension?
The current philosophy is akin to rearranging deck chairs on the Titanic.
Why is heart disease even occurring?
What is beyond clear is that drug companies and current approaches have failed miserably. After all the billions we have nothing but patchwork procedures perfumed heroically to save extremely sick people.
Drug interventions are mostly worse than the original disease. This much is as clear as day and can be confirmed in less than 5 minutes of internet research.
Other approaches must be studied, funded, and tested.
We have run the course on contemporary heart disease treatments and they are, collectively, a failure too big to grasp. We need new thinking and different approaches. Because as it stands now doing nothing appears as effective as all the heroic interventions, clinical and chemical, combined.
So how do we convince Americans to take better care of themselves? Is health care reform going to help? The magnitude of the American diet and the easy life is an enormously difficult issue to tackle. Perhaps tax incentives for joining a gym or losing weight might work. Money in Americans' pockets provides a greater incentive than political policy. All of this will take decades to fix. So what do we do in the short term? Seems like medicine is at least a stop gap.
So how do we convince Americans to take better care of themselves? Is health care reform going to help? The magnitude of the American diet and the easy life is an enormously difficult issue to tackle. Perhaps tax incentives for joining a gym or losing weight might work. Money in Americans' pockets provides a greater incentive than political policy. All of this will take decades to fix. So what do we do in the short term? Seems like medicine is at least a stop gap.