Imagine sitting in front of the TV, casually flipping channels as you ate dinner, and then you saw your cardiologist on a local news channel. You pause for a moment to listen for praises, but instead you find out that the doctor that had operated on your heart was being sued for medical malpractice.
That’s exactly what happened to a woman in Indiana last spring. Debra Davidson was horrified to find out that her long-time physician who ordered and conducted her open-heart surgery was accused of performing unnecessary operations by two of his other patients.
Since then, 293 patients have filed medical malpractice lawsuits against Dr. Gandhi for a variety of needless operations and prescriptions. Cardiologists have been under the microscope on many occasions for performing unnecessary procedures such as placing stents and pacemakers. While officials say that there are not necessarily more needless operations performed in cardiology than in other specialties, the heart doctors tend to see more of the spotlight since insurance providers usually pay out more for cardiology.
“Cardiology, whether we like it or not, is generally a big moneymaker for hospitals,” says Dr. Steven Nissen, the former president of the American College of Cardiology. “We are still a fee-for-service system, and that creates, in my view, misaligned incentives among some physicians to do more procedures and among some institutions, particularly in areas where there is not tight medical supervision, to turn a blind eye and enjoy the high revenue stream,” he added.
Unfortunately, even though there are a variety of regulations and rules in place, doctors are still allowed to use subjective judgment in most cases. For example, Medicare requires that a patient’s artery be blocked 70 percent or more to justify placing a stent, but a doctor can make a different decision and claim medical necessity, or falsify medical records to show a more blockage that there really is.
In this case, Dr. Gandhi’s practice was the most profitable in the state according to Medicare reimbursement records despite being located in a relatively small community, which may be strong enough evidence of misdealing on its own.
Targan Pender & Strickland, P.C. – Atlantic City medical malpractice lawyers