In 1911, George Bernard Shaw famously wrote “All professions are a conspiracy against the laity”.
One hundred years later, in 2011, I write “the MBA has done more to harm the public through bottom-line hospital administration than have many dread diseases.”
As an example, the continuing saga of this stent, that stent, the other stent placed into as many coronary and other arteries as often and as fast as possible does show some signs of waning.
One of my favorite journalists, Maggie Mahar, has been writing about the stent problem as well as many other overuses of TOL (technology for lucre), in columns and her book, Money Driven Medicine, for many years.
And Dr. Nortin Hadler, a professor at UNC in Chapel Hill has a number of books that document the mass misbehavior of American medicine at large for many years.
The problems conclude that the overuse and misuse of medical procedures is so widespread as to now be accepted as “conventional wisdom” and institutionalized as “standard of practice.”
The academic medical centers are the worst because they posture as presenting the best medical science while practicing as the largest generator of the most revenue for their institutions.
And they thereby teach the students and residents to emulate them, doing with great competence loads of procedures that don’t need to be done at all.
Here’s my take on how different actions such as those Maggie, Nortin, and I are advocating here would save vast sums of money.
And, for the best science on use of stents that should best inform the decisions for you and your patients, look yourself to the clinical trials called RITA-2; BARI-2D; OAT; and COURAGE.
Don’t continue to be entrapped by the AMMM, the American Medical Marketing Machine.
George Lundberg is a MedPage Today Editor-at-Large and former editor of the Journal of the American Medical Association.