John Fisher
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Stopping Medical Injustice
If you have heart disease and live in New York, your doctor may not be telling you all of your treatment options. According to new research by Edward L. Hannan, the Dean of the University at Albany's School of Public Health, Hannan argues that "while medication or open heart surgery may be as effective or better for many patients", financial incentives for the hospitals cause New Yorks "to be pushed to have invasive cardiac procedures such as angioplasty and stenting procedures" instead. According to Hannan, "Invasive cardiac procedures are attractive to U.S. hospitals because they are highly profitable and generate considerable revenue for hospitals".

Medical research shows that patients that have open-heart surgery live longer than those that have PCI procedures. PCI procedures, while they may alleviate symptoms of heart disease, may not lengthen life expectancy. Even so, earlier research by Hannan suggests that procedures such as angioplasty and stenting procedures (procedures also known as percutaneous coronary interventions (PCI))are grossly overused. According to his research, 93% of patients who would have benefitted from either open heart surgery or PCI were recommended for PCI. 34% of patients whose condition suggested that surgery was the best option, "were steered toward" PCI, while 53 percent were told to get the surgery.In fact, according to Hannan, New Yorkers have twice the number of angioplasty and stenting procedures than those from Ontario, despite the fact that there is no difference in the rate of heart disease within each city.

If Hannan's assertions are true, I am alarmed by the fact that hospitals and doctors would have such disregard for their patients' well-being. While non-PCI procedures such as open heart surgery can be more time consuming, and require more recovery time, I do not think that cardiologists should suggest PCI procedures to patients that need surgical procedures just because of some financial incentives. Furthermore, I am concerned by the fact that PCI is utilized so frequently since medical research suggests that other types of surgery are more likely to lengthen patients' lives. I hope that cardiologists and other doctors become more aware of the benefits of non-PCI procedures and do not allow themselves to be swayed by financial incentives.

 If you are a patient with heart diesase, research both PCI and open-heart surgery. If your condition warrants surgery, do not be swayed to undergo PCI solely because it seems easier. It may not lengthen your life; it may only lessen your symptoms.
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