More is not better when it comes to healthcare

Here we go again! You’ve probably noticed I’ve been posting a lot about fraud in healthcare because it appears to be so prevalent. Well, I consider overtreatment to be a form of fraud, especially, when published practice guidelines are not followed. The NY Times reported that more than 25,000 defibrillators-22.5% of the total- that were implanted into patients between 2006 and 2009 did not meet the published guidelines. Shockingly, 37% of the unnecessary implants were put into patients who had suffered a  heart attack shortly before, which the guidelines definitely show is inappropriate (based on two clinical trials).

Dr. Khatib, lead author of the study reported in the journal JAMA,  said “she thought many doctors did not know the guidelines or understand the evidence behind them, and thought they were helping patients by putting in the devices to save them just in case their heart rhythms went awry”.

This is pretty scary stuff. As Dr. Khatib says, ”implanting the device is not minor surgery. It is an invasive procedure. You’re putting wires in the patient’s heart. You’re putting a needle in the subclavian vein next to the lung, threading two wires down to the heart, and implanting the device.

And in some patients we test the defibrillator by causing the heart to go into a life-threatening rhythm, to make sure the defibrillator can recognize it and shock them out of it. It’s not a minor procedure by any means.” Patients who did not match the medical guidelines for receiving an implant but were given one anyway were more likely to die in the hospital or suffer complications than people who got the device and met the guidelines. Yikes!

Well, you know I’ve been preaching all along that we must become more involved with our healthcare. But, this is ridiculous! Now, we must become cardiologists! I expect my doctor to be the expert when it comes to his field of expertise, which means reading the relevant literature and practicing evidence-based medicine. You cannot claim ignorance when it comes to practicing bad medicine; that’s fraud and malpractice.

People, it’s dangerous out there, be careful and do you homework!

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