"The most important point of our paper, the biggest take home message...is the substantial variability between hospitals in these elective cases in terms of the degree of inappropriateness," Ralph Brindis, MD, past president of the American College of Cardiology and an author of that JAMA report, told me in an interview last week.
"Feeding back this data will help hospitals and clinicians re-examine their practice patterns, so we can try to eliminate angioplasty where there is no value," he said.
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Other evidence that PCIs are being inappropriately performed comes in a gaggle of recent highly publicized state and federal complaints that specific doctors bilked federal and private payers millions of dollars for unnecessary stent and other angiography procedures.
In just the last few months at least seven doctors in Tennessee, Maryland, Pennsylvania, Texas, and Louisiana faced penalties and accusations for performing unnecessary cardiovascular procedures in hundreds of patients.
For example, one patient received 32 stents and another 25, far above the average rate of a mere 1.6 per patient. A few hospitals now being targeted, may have known about such schemes but failed to stop them.