The Heart Scan Scam

I can easily imagine one of those “good news bad news” jokes coming out of this.

Doctor: I have some good news and bad news.
Patient: What’s the good news?
Doctor: The results from your heart scan look great.
Patient: That’s fantastic. What’s the bad news?
Doctor: As a result of all the radiation from the heart scan you now have cancer.

This past Sunday, the front page of The New York Times featured a story entitled “Weighing the Cost of a CT’s Scan’s Look Inside the Heart.” According to the story, these CT (computed tomography) scans “expose patients to large doses of radiation, equivalent to at least several hundred X-rays, creating a small but real cancer risk.”

And here’s the thing, the benefits of these scans is somewhat dubious. The article claims that these CT heart scans "have never been proved in large medical studies to be better than older or cheaper tests.”

That hasn’t stopped some docs from prescribing them for their patients though. In the past year alone over 150,000 people have been given CT scans for their heart.

So why would a doc prescribe a test that may expose his patient to a cancer risk?

The answer is quite simple. Many of the docs prescribing these scans hold an ownership position in the equipment being used. A CT scanner costs around a million bucks so a doc would need to perform around 3,000 scans to pay back his or her investment.

It’s not just the docs either. Hospitals that have invested in CT heart scanners are also motivated to recoup their investment.

It kind of reminds me of one of my favorite quotes by Elbert Hubbard. “When a fellow says, “it ain’t the money but the principal of the thing,” it’s the money.”

A Home Appliance You Can Probably Do Without

Have you ever considered getting a defibrillator for your home?

Yeah, me neither.

I suppose that if I lived in the Australian Outback owning such a device might make sense.

Then again maybe not.

According to this story in yesterdays New York Times, “researchers found no evidence that the devices produced significant life-saving benefits .”

I guess they still could be used to try and “shock” some sense into a mouthy teenager though.

Stent versus Bypass

Tonight, on the NBC Nightly News with Brian Williams, in a story entitled “Medical Matters of the Heart” Robert Bazell reported on a new study of 8,000 patients which determined that bypass surgery is better than the stent procedure for avoiding the recurrence of a heart attack.

Now they tell me.

On the other hand, the story goes on to say that the difference is only 2%. That doesn’t sound like much of difference, and for that matter, much of a story to me.

Bad Message

I was driving to my office holiday party last night when an ad came on the radio for St. Joseph’s Medical Center in Baltimore. The ad, which was playing on the all Christmas music station WLIF, began with a recap of the warning signs of a heart attack. That part was good. Then the ad went on to extol the expertise of the hospital in dealing with heart attacks and went so far as to suggest that if you are having a heart attack you should make your way to St. Joseph’s Medical Center…wherever you are.

Considering that the listening area of this particular radio station covers a pretty broad geographic area, that would seem to suggest that someone suffering from a heart attack should bypass all of the other metropolitan area hospitals, including Johns Hopkins, and drive directly to St. Joseph’s.

Now this is a non clinical blog about heart disease so I won’t attempt to provide any medical advice but, everything I’ve read and been told about a heart attack is the time matters. If you were to follow the advice of this advertisement and end up driving over an hour to get to St. Joseph’s as opposed to a closer hospital wouldn’t you be putting yourself in jeopardy?

Paperwork

The EOB’s just keep coming. I am referring to the Explanation of Benefits statements that I get from Carefirst Blue Choice for the charges related to my heart attack and resultant treatment. Now I realize that I should be grateful for the fact that I have health insurance. I am.

The thing is I thought I’d try to add up what this little cardiac episode of mine actually cost. They don’t make it easy. To me it is as if you went to a hotel and they billed you separately for everything. You’d get one bill for the room, one bill for breakfast, one bill for a spa treatment and so on.

And these EOB statements don’t really tell me anything either. More space in the statements is devoted to legal disclaimers than an actual explanation of the benefit they paid for!