Tuesday, November 15, 2011

Makes Us Look Bad

In a recent JAMA study on 17,847 patients who had cardiac bypass surgery or coronary angioplasty, it was found that doctors prescribed nuclear stress tests and/or echocardiograms later than 90 days after discharge more often if they had financial interests in the tests.  For stress tests, it was 12.6 percent of docs who prescribed the test versus 5 percent of those who were not paid for testing. For echos, it was 2.8 percent versus 0.4 percent.  This sucks.  It makes us look bad.  Doctors are human and if they are on the fence in any way about doing a test then it seems they will lean towards ordering what pays them better.  That being said, there are some outliers in any occupation who just don't care and abuse the system.  Also, some teaching programs don't follow the same rules.  Heck, I remember in medical school the hot shot cardiologist ordering an "echo, Holtor, MUGA" test on EVERY patient.  And he was the chief editor of Circulation, a prestigious journal!   Yes, I am well aware that mentioning the MUGA test does give away my age.