Did a New York Times column unfairly attack ER doctors?

Cardiologists are causing patients to get cancer.

It’s true.

Cardiologists routinely perform angiograms on patients who have no heart disease whatsoever.

As shown in this Harvard newsletter, each angiogram exposes the patients to about 7 mSv of radiation. Add in the myocardial perfusion imaging at another 25 mSv of radiation and you have enough radiation to cause cancer in an otherwise healthy individual.

And cardiologists routinely subject patients with normal coronary arteries to this dangerous testing … as can clearly be seen by all of the normal angiogram results.

Not only does this type of wasteful testing line the pockets of the cardiologists who order, perform, and interpret the tests, but it is dangerous to the patients and can lead to many types of cancer in the patients that the cardiologists are supposed to be helping.

In fact, Dr. Rita Redberg could personally be responsible for multiple cancer deaths due to radiation from angiograms she has recommended on patients with normal coronary arteries throughout her career.

Fortunately, we can reduce the rate of medical imaging by simply avoiding unnecessary scans on patients with normal coronary arteries and minimizing the radiation from appropriate testing. Practices such as performing angiograms on patients with normal coronary arteries, for which there is little or no evidence of benefit, should be eliminated.

Wait. Did I hear some cardiologists objecting? Cursing my name?

What’s that, you say? There’s no evidence for the allegations I’m making? They’re preposterous?

Yeah, you’re probably right.

But it’s interesting because the last paragraph parroted the assertions that a colleague of yours made while discussing emergency physicians in the New York Times. In her column, Dr. Rita Redberg stated,

… fortunately, we can reduce the rate of medical imaging by simply avoiding unnecessary scans and minimizing the radiation from appropriate ones. For example, emergency room physicians routinely order multiple CT scans even before meeting a patient. Such practices, for which there is little or no evidence of benefit, should be eliminated.

No basis for her statements. No scientific evidence. Just some cheapshot about emergency medical care that she obviously knows little or nothing about.

This type of statement should seriously draw into question any of the other statements of scientific “fact” that Dr. Redberg makes.

And if the cardiologists and the American College of Cardiology are outraged by the unsubstantiated assertions in this post but don’t take issue with Dr. Redberg’s New York Times misstatements, then they are just as dishonest and misinformed as Dr. Redberg.

WhiteCoat is an emergency physician who blogs at WhiteCoat’s Call Room at Emergency Physicians Monthly and Dr. Whitecoat.

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  • Paul

    You could put a period after the word “attack” in the title and answer the question “yes”. Further reading is not necessary.

  • bmniac

    It is clear that both NY Times and Dr Redberg could have avoided such criticism, but it is possible to deny that what they say does indicate a serious perception problem, at least. Part of the problem is created by the Insurance industry and malpractice litigation but certainly not entirely. It behooves on the profession to introspect on such matters at least to justify the average patient’s faith in doctors.

  • T H

    After reading her little fluff article, she’s welcome to come evaluate my patients for me, then… AND talk with the trauma surgeons/neurosurgerons who are 1-2 hours away about what my patients ACTUALLY need.

    • T H

      Oh. And she tosses out Ultrasound and MRI as if they are viable alternatives available everywhere. Competent Ultrasound techs are worth their weight in platinum. And MRIs? Please. Even the level 2 trauma center two towns over doesn’t have one. And MRIs won’t take the place of a good trauma CT until they get (a whole lot) faster and can routinely handle patients who are 300+ pounds.