Again and again, studies have shown that doctors tend to make clinical decisions on patients based on how much they will be paid.
In 2007, we erudite From the courage test that angioplasty and stents – PCI (PCI) – do not reduce the risk of death or heart attack, but patients did not seem to take the note. Only 1 percent realize that there was no mortality or benefit of heart attack, perhaps because most cardiologists fail Let me mention this fact. One can imagine that if patients actually understandable This symptomatic relief was what they were going to get, with “no additional mortality”, would be less likely to go under the knife. Then ten years later, the Orbita test was publishedeven showing the promise of relieving symptoms was an illusion.
‘The consequences of Orbita hectare deep and extensive. First of all, Orbita results show no doubt that there are no benefits for PCI compared to medical treatment for constant angina “, ie heart disease. Basically, patients would be risks “Harm for no benefit, it is difficult to imagine a scenario where a fully up -to -date patient will choose an additional invasive treatment for no additional benefit.” Remember the consent form debated Previously, it appears below and at 1:17 in my video Why are stents still used if they don’t work?:
Now, that appearance Like this, seeing below and 1:21.
So, is The Orbita test the “last nail in the PCI coffin in stable angina?” That is, for stents in non -emergency situations? A constitution in the magazine Cardiovascular Revolution of Drugs disagreementshowing “the broad angina relief that happened in both hands”. In other words, the stents have helped – even if the fake business without stents helped just as much. So, “If the patient is treated with PCI and benefits from” placebo “, who am I to intervene in this benefit of this” treatment “?” In this case, why not perform fake surgeries? box It costs about $ 40,000. It would be cheaper to fake them all. The reason you should not keep People’s electoral stent is because there is a number of body. During Stent’s placement, 2 % of patients develop Bleeding or damage to blood vessels, while another 1 percent die or have a heart attack or stroke. And because something is stuck in your chest, 3 % of patients have an event of bleeding from the blood diluting to be taken. Or blood diluing do not work and stent clots and cause a heart attack.
Because they still do when not only do we have no evidence of benefit but, in many occasions, we have clear “evidence for no benefit”? One of the sources of resistance can be all the financial gain. These procedures brand A lot of money for hospitals. Do not expect to start promoting “lifestyle changes to combat heart disease. Neither doctors will quickly abandon a practice that supports both of their incomes and seems to make sense.” Is it so simple? Is This famous Upton Sinclair Offer: “It’s hard for a person to understand something when his salary depends on not understanding it.” Think it’s just cynicism? Let’s ask the doctors themselves.
Thousands of doctors were respondentAnd 70 % “believed that doctors provide unnecessary procedures when they benefit from them”. This is what the doctors themselves believe. And the data bear This out. Doctors have been shown to make clinical decisions for patients based on how much they are paid. For example, when choosing Which chemotherapy for the treatment of breast cancer, increasing a 10 percent doctor’s margin can bring up to 177 percent increase in the chance of choosing one drug over the other.
This may be the reason why caesarean sections “are more likely to be executed from speculative hospitals compared to non -profit hospitals. ““Operating in commission. “Pay the surgeons per procedure and you can increase surgery rates by 78 %. do 101 percent more pottery than any other wealthy country? A study of physicians’ financial incentives and treatment options in the management of heart attacks “found that they actually respond positively to the payments they receive and that the answer is quite large … unconditional, plans that pay more for doctors for more invasive treatments, can be more involved.” It is quite common for patients to receive different treatments based on whether the doctor is paid by procedure.
One of my heroes, Dr. Caldwell Esselstyn – who always he is trying To see the best in people – to admit that compensation can play a role. Evidence inherent that “doctors have run millions of dollars in medical accounts making unnecessary stent implants”, doctors like Mark Midei Who Who imported 30 stents in a day. This could be about a million dollars worth a billing value. As a sample of gratitude, a Sales spokesman from Stend spent more than $ 2,000 to buy “a whole slow smoked pig, peach and other accessories for a barbecue dinner at Dr. Midei’s home”.
‘US is just the only developed country where healthcare is surrender On the basis of a fee and we are very liberating doctors to do invasive procedures, “explained the head of cardiovascular medicine at the Cleveland Clinic.” Financial incentives are just very powerful. ”
