As a result, we pay moreand moreand moreas drug makers and device-makers flood the market with new, improved products., In Money-Driven Medicine: The Real Reason Health Care Costs so Much, I quote Kaiser Permanente CEO George Halverson who points out that few modern researchers are willing to risk betting their own money on their newest products or procedures. .The Texas Medical Board last month accused a widely known cardiologist in Austin of inserting unnecessary stents. they are very tired), too many unnecessary and expensive tests, etc. But in your last paragraph I think you mean but the studies are NOT very effective ??? Wall Street likes them too. WebDr. blow the whistle on other doctors. Dr. Samir Sharma has a 4.5/5 rating from patients. Meanwhile, Medicaid pays them less than 70% of their costs with more payment reductions coming due to state fiscal pressures. health, Transgender If it works, well pick up the bill. I have a different take on this. Midei was a rainmaker. If it can be demonstrated that a doctor was willfully negligent or engaged in fraudulent behavior, many, perhaps most, malpractice policies have clauses that obsolve the insurance company of responsibility, potentially leaving the doctor responsible for the entire cost of settlement or judgements themselves. Zones Project, Find In other words, it seems that the hospital encouraged the doctor to implant those tiny mesh tubes in his patients arteries. Physicians and hospitals also can receive bonuses of as much as 10 percent by doing well on nationally recognized process and outcomes measures. In July 2009, Dr. Sharma launched a monthly live web series, (www.ccclivecases.org), a revolutionary teaching tool in nterventional cardiology globally. They were included with Mount Sinai Beth Israel and are not repeated here. (You will find the abstract here) Following a two-year study, researchers at the Cedars-Sinai Medical Center in Los Angeles are now suggesting that the putative superiority of drug-coated stents is founded on questionable premises. Or as The Wall Street Journal put it, the clinical trials of drug-coated stents (mostly funded by manufacturers), may have exaggerated their real-life advantage. [Dr. Midei was using a new generation of drug-coated stents.]. Hamburger and treating Crohns disease, You It is very very hard for doctors to admit to themselves that something they have been doing for a while is now demonstrated to be of little value or even potentially harmful. There will be incentives to join Accountable Care Organizations where doctors or doctors and hospitals work together, and all share in the financial rewards if they are able to avoid waste. control of type 2 diabetes, Diet In gratitude, the hospital pampered them with department chairmanships and perks. Sharma served on the Cardiac Advisory Board of New York State from 2004-2016, which advises the Health Department and the Governor on issues of health policies and supervision, safety, and appropriateness of heart care by various hospitals in New York. But this is an example of how insurers can add value to health care, not by trying to make treatment decisions themselves, but by calling for more collaboration. . professor, infectious diseases: $616,469: ), Will the Supreme Court Scuttle Obamacare Subsidies? With regard to the studies that claim to show that there is no benefit from stents regarding either life expectancy or preventing future heart attacks or strokes, they dont speak to the quality of life implications of reduced chest discomfort. As Americans we tend to believe in whats newas if medical science progressed in a straight linear fashion, one breakthrough after another, from Madame Curie to me. The physician himself becomes part of a mass cultural delusion about the efficacy of certain procedures. WebDr. I dont understand why and under what circumstances asymptomatic patients would ever be sent to the cath lab in the first place. While it is possible that no St. Joes leader knew precisely what was happening, Im guessing that some did but chose to look the other way: the pressure to steer clear of the golden-egg-laying goose must have been intense. Upasna Sharma (photo by C. Lagattuta) Upasna Sharma, assistant professor of molecular, cell, and developmental biology at UC Santa Cruz, has received a $1.18 doctor, Find Samir Sharma - Campbell, CA - Orthopedic Surgeon Reviews & Ratings - RateMDs. Medicare wants to put hospitals under some fianncial pressure because MedPAC reserach shows that when hospitals are under financial pressure, they learn to become more efficientand, in fact, beginning making a profit on those Medicare reimbursements. But doctors can go to jail for malpracticetypically if they are found guilty of fraud and malpractice. I am afraid that many hospitals have resisted the news for one simple reason: procedures that involve stents are extremely lucrative. Yet the odds that the bleeding-edge therapy represents an improvement over existing technology are only about 50/50. Each webcast receives >5000 page views globally. Sharma accepts several types of health insurance, listed below. Thats a heavy lift in the current fiscal environment. . Administrators at the California hospital should have realizled that something unusual was going on. If the allegations against Midei are true, it strains credibility to think that no one in the lab knew that inconsequential lesions were being read as tight stenoses and treated with stents. Titles reflect positions held in 2019. Oh, and by the way, it pays well too. In 2005 THCB questioned the cost-effectiveness of the new, improved drug-coated stents that are designed to prevent the growth of scar tissue inside the artery. A regular fixture on international, national, and local TV stations, newspapers and magazines, Dr. Sharma has been the focus of news stories for media outlets like: The Today Show, CBS News, NBC News, Fox News, PIX11, The New York Times, The Wall Street Journal, New York Magazine, Reuters, Businessweek, Cardiology Today, India Abroad, India Today, Barrons, Forbes, Newsweek, The Washington Post, CrainsNew York Business, NY Daily News, Newsday and New York Post. Yes, the Redding story eptiomizes what has been happening. As for hospital CEOs at overpaid hospitals in NYC and PIttsburgh who tell you they couldnt surive on Medicare paymtents? "Other compensation" includes nonreportable compensation, deferred compensation, retirement-plan benefits, health care benefits and other fringe benefits from the organization and related organizations. At a cost of $400,000 a year, he figured, the hospital could put enough doctors and nurses on call to do emergency angioplasties late at night and on weekends. Barry This provider has 21 years of experience and is affiliated with Catholic Dr. Sharma travels to India every month to teach the art of angioplasty to Indian cardiologists. We are being enormously group-stupid in not bringing the roof down on the bad boys of medicine. Sharma also wanted to let us know that the Chronicle's list failed to include Sharmas own salary of $2.75 million which would have put him ahead of Moses., Health Care Reform Legislation Points to Solutions, Bob Wachter recalls that when the Midei scandal broke, a reporter asked him Why didnt peer review catch this?. But some do set out to over-charge insurers, Medicare or Medicaid, and sometimes the patient suffers the collateral damage. Try Hummus. Were spending a fortune as a country on procedures that people dont need.. 6- Mo was president of Mount Sinai Brooklyn until mid-2018 and served as a system executive vice president until January 2019, when he left Mount Sinai. professor, cardiology: $5,173,001: $1,161,279: $4,011,722: $42,531 A well-trained internist can take care of the lions share of people with coronary heart disease. Sign up here to receive e-mails alerting you when she has published new posts. Medicare beneficiaries should expect a typical cost of $158.18 with an average copayment of $39.54 for new patient appointments. Samin Sharma, MD, is a specialist in internal medicine who treats patients in San Antonio, TX. He got in touch with the blog to point out that he performs 1,500 complex coronary interventions each year, which apparently is an American record, Cardio Brief noted. relations, Breast This is because they are terribly inefficient. Although St. Josephs has not admitted to any wrongdoing, last month it agreed to pay a $22 million fine to settle charges that it paid illegal kickbacks to Dr. Mideis medical practice in exchange for patient referrals. Cardiologists dont perform caths on desert islands they are assisted by cath techs and nurses. Dr. Sharma received his medical degree from S.M.S. Medical College in 1978, Jaipur, India, where he was ranked the number one student in his medical school and State University receiving eight gold medals and five honors. Wachter goes on to suggest that team work can also reduce medical errorsincluding overtreatment. (Im pretty sure I know the hospitals you are referring to) What did you think these CEOs would say? I feel like [Dr. Midei] saved my life., Moreover, Im guessing that Dr. Mideis complication rate was quite low, Wacther continues, as it usually is when one does procedures on healthy people. . The interesting thing is that the article in the Times suggests that the tide has turned and that doctors are actually at greater risk of litigation from DOING the procedure than from NOT DOING it. | policy, Press The business address is 20 Castle Walk, Scarsdale, NY 10583-3221. Capitation has remained more common the West, where HMO penetration remains greater. All, About He said that patients suffering from anginawho have never had heart attacks- undergo these procedures. Obamacare Fines: How to Escape a Hefty Penalty If You Really Cant Buy Insurance. a doctor, Find I interviewed some of the victims of Redding when I wrote Money-Driven Medicne. Omix, Health and degeneration, A * Please verify this information when scheduling an appointment. Steamed Veggies or Raw Veggies for Healthy Cholesterol? I have been researching, investigating, speaking & writing on the ugly reality of physician misbehavior for more than a decade. 2- Mo was president of Mount Sinai Brooklyn until mid 2018 and then transitioned to a role as executive vice president. Barry I would love to see the Times expand on these comments by exploring the larger national problem. Would you still like to make an appointment with Dr. Sharma, or would you like to choose another provider and have an online appointment right now? In my experience, these folks become as adept at reading cath films as any physician. Its not that easy for them to reduce costs in the short term. Dr. Samin Sharma, MD is affiliated with Mount Sinai Hospital, Mount Sinai West, Mount Sinai Morningside and Mount Sinai Beth Israel. Meanwhile patient care suffers in the fee-for-service environment. Medicare will not force physicians to give up fee-for-service, but those who cling to being paid piece work are less likely to be eligible for the bonuses that reward collaboration and better outcomes. center, Health training you makes doctors extremely sensitive to criticism. Dr. Samir Sharma, MD, is an Orthopedic Surgery specialist in Campbell, California. At the same time, they could lead to even greater concentration of market power which could result in healthcare costs even greater than they would have been under fee for service even with global payments, bundled payments for surgical procedures or partial capitation. us, Close 5- Several officers are listed on Forms 990 for multiple hospitals within Mount Sinai Health System. Find contact information here to make an appointment. May 25, 2021Pulse Extra is available every Tuesday. Barry In addition, of course, doctors are subject to investigation and censure by their hospitals, potentially leading to loss of privileges (the right to work in the hospital) or other lesser sanctions, and by state medical boards, potentially leading to loss of license or other lesser sanctions. Dartmouth helped expose the problem. . No one can ever tell me that I didnt need that stent, she told the Baltimore Sun. This edition of Pulse Extra highlights the highest-paid people working for New York City institutions in 2018. In my own case in 2005, there were some symptoms and a stress test showed a significant adverse change from my prior stress test a year or so earlier. patients guide to Graves' disease, Understanding As Pat S. points out, in his comment, anecdotes (or stories you hear from people with an ane to grind) are one thing; MedPACs well-documented analysis is another. Medical Journals Have Been Telling Us This for Years. Actually, I did say that asymptomatic patients undergo cath and stenting, under the circumstances that I outlined in my answer to Barry. and fitness, Sleep Cases like this one are terribly troubling, he continues, not just because they harm individual patients but because they do violence to the trust that is so fundamental to the physician-patient relationship. In many cases, the malpractice insurance that was in force for the incidents had been acquired two decades earlier and had cash limits that were way too low for the settlements and judgements that were being given, leaving the pediatricians, many of whom had already retired, to pay 7 figure awards out of their own pockets. This provision is designed to put pressure on hospitals to become more efficient. A more practical reason is that doctors are concerned about being sued if they try to Yes, Dr. Samin Sharma, MD holds board certification in Cardiology, Cardiovascular Disease and Internal Medicine. Titles reflect positions held in 2018. For example, the Sun reports, "Dr. Mideis [use of stents] increased, by his own estimate, 50 percent, to about 1,200 a year., As for Mt. cancer, Weight Dr. Sharma is able to speak Hindi. , The Times went on to quote Dr. Steven Nissen, chief of cardiovascular medicine at the Cleveland Clinic: What was going on in Baltimore is going on right now in every city in America. Nissen added that he routinely treats patients who have been given multiple unneeded stents. plan, Public I felt relief., Although this patient, 66-year-old Peggy Lambdin, later received a letter indicating that her coronary artery was less than 50 percent blocked (clinically meaningless and not an indication for stenting), she was unfazed, Wachter observes. The problem is that some, probably many or most, cardiologists believe that once they discover what they consider to be a significant stenosis they more or less HAVE to treat it to prevent it from causing the patient problems down the road. By the end of 2006 the hospital's total patient revenues had grown 41%, to $1.2 billion. There, two rogue cardiologists, Chae Hyun Moon and Fidel Realyvasquez Jr., headed a team that performed extraordinary volumes of unnecessary and recklessly dangerous heart operations. For heart patients, medication, and diets like Bill Clintons plant diet are likely to be favored. It makes a lot of sense as usual. Very sad stories. Ive seen it from the inside and out. Health Care almost never reports its own miscreants to authorities, as they are mandated by law to do.
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