Thousands of Americans are going under the knife every year for surgery that isn’t necessary, according to a USA Today investigation. After reviewing information from government records and medical databases, USA Today concluded that unnecessary surgeries may account for 10 to 20 percent of all operations in some specialties. Unfortunately, although the scope of the problem is huge, it remains largely hidden. Public attention has been limited to few cases, typically involving doctors who put cardiac stents in patients who didn’t need them.
Two lawsuits have been filed against King’s Daughter’s Medical Center in Ashland, KY. The suits allege that doctors performed medically unnecessary cardiac procedures, including coronary angioplasty, stenting and coronary artery bypass grafts and pacemaker and defibrillator implantation. These surgeries left many in physical and emotional pain; some patients died. The hospital and the other defendants have denied wrongdoing. Kristie Whitlatch, King’s Daughters president and chief executive officer, said the hospital will defend these claims and the reason for such a large number of plaintiffs is for a “shock factor” to get attention.
How’s this for “shock factor” (and not the kind Ms. Whitlatch is referring to)? According to a Bloomberg report, federal investigators have been probing King’s DaughtersMedicalCenter since 2011 looking into whether some doctors at the hospital were implanting stents in some patients who may not have needed them. The probe is part of a bigger U.S. Department of Justice investigation that started in 2006 focusing on allegations that hospitals across the country billed public health programs for unnecessary stents to make extra cash.
It is difficult to really know the full scope of the issue because many cases go unreported. The federal government doesn’t currently require hospitals to track data on these types of errors, and not every patient who undergoes unnecessary surgery will file a lawsuit. Although this is a serious public safety concern that must be addresses, patients should take step to protect themselves by researching the procedure (there is an abundance of information ion the internet), asking questions, including what will happen if I don’t have the procedure, and seeking a second opinion. Studies have shown that requiring a mandatory second opinion leads to a 20 percent drop in some surgeries that tend to have a higher rate of unnecessary procedures. Click here for a list of the 90 most common unnecessary tests and procedures.
@thumbnail.jpg "Mark M. Bello")
Experienced attorney, lawsuit funding expert, certified civil mediator, and award-winning author of the Zachary Blake Legal Thriller Series. The series features super-trial lawyer Zachary Blake handling "ripped from the headlines" legal and political issues of the day. The series currently consists of Betrayal of Faith, Betrayal of Justice, Betrayal in Blue, Betrayal in Black, and Betrayal High, with a sixth Zachary Blake novel due out later this year. To learn more about these topical social justice legal thrillers. please visit markmbello.com. Mark is a member of the State Bar of Michigan, a sustaining member of the Michigan Association for Justice, and a member of the American Association for Justice.
10 Comments
Vern Dennis
Of course, a certain percentage of these unnecessary surgeries are clients pushed by personal injury attorneys into having the surgery in order to build up the medicals for the personal injury claim
Mark Bello
Vern: So now the big, bad personal injury lawyers are telling clients to have surgeries they don't need? What is your source for that? This post reports a study by USA Today and an eight year investigation by the U S Department of Justice. In 2006, the President was George W. Bush; you can't even blame Obama! What study of personal injury lawyers supports your accusation?
Mark Bello
Not to mention that, in your outrageous scenario, an unscrupulous doctor would still have to agree to perform the surgery, right?
Vern Dennis
Exactly, Usually the profession owned by the plaintiff bar is that of the chiropractic "arts"; however, there are some crooked orthopedic surgeons who cut first and ask questions later.
Personal experience is my source, Also I was instrumental some years back in helping members of a fraud ring receive some well deserved slammer time
When Herb Denenberg conceived of No-Fault years ago, it was as a replacement for the tort system, not as a means of financing it. I don't handle Michigan claims but I suspect the amount of mischief occasioned by its unlimited No Fault benefits is enormous
Mark Bello
Vern: I can't comment on what the medical profession does or doesn't do. I was reporting on an ongoing study/investigation. Why are "fraud" investigations always on the plaintiff side of things? Isn't it "fraud" for an insurance company to send a seriously injured person, desperately in need of treatment, to a doctor whose sole responsibility is to say the client doesn't need the treatment? These "cut-off docs" operate with impunity. Their behavior is the true tragedy of personal injury litigation. They prostitute false negative findings for money. Is this OK with you?
jc
What everyone is missing here are standards for necessary and unnecessary procedures. Say a patient comes in and has a pharmacologic cardiolyte stress test which shows myocardial ischemia. The patient is an elderly amputee with a stroke and therefore cannot exercise. Say a cardiac catherization is done showing 50% stenosis of the left anterior descending coronary artery. The patient only has ischemia when stressed and because of an amputation and stroke, the patient cannot stress. 50% stenosis is a borderline lesion to do a cardiac angioplasty and stent. So if the cardiologist does an angioplasty and stent, is that an unnecessary procedure? There would be honest debate about this on both sides of the issue. On the other hand, there would be no debate about doing an angioplasty and stent on a similar lesion in a patient in his 50s with no co-morbid conditions and an active lifestyle and angina.
Mark Bello
John: No question that what you say is true. This is not a simple issue. There are or should be standards. But, what is being talked about in the study and investigation are obvious situations where surgery was performed unnecessarily. I don't think the circumstances that you refer to are those the study and/or investigation concerns itself with.
jc
Mark, right now there is an investigation and allegations. My post points out some of the gray areas regarding stents. It is a long way from allegations of unnecessary procedures to fraud. To my knowledge, the lawsuits have not resulted in guilty verdicts, and until that happens there are nothing but allegations.
Mark Bello
John: I agree with you. I'm just pointing out that the scenario you proffered is not what they are investigating. Further, there was an allegation by Vern Dennis that attorneys are "pushing" clients to have the unnecessary surgeries that are the subject for this investigation. I'm still waiting, with baited breath, for the source of this outrageous accusation.
Pete Mackey
Great post, Mark. Some doctors and hospitals have been very aggressive on their billing codes, believing that the insurance companies are looking to feather their own nests instead of looking out for patients (who'd of thought?). Some of it is legal, some crosses the line. In related fashion, I believe that some medical professionals are crossing that same line and putting in unnecessary stents. I also believe that they are in the severe minority. As in all professions, there are those who care more about a dollar than the oath they took. Thanks for putting the light of day on this - no matter what your point of view is, it's an important issue.
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