The Treatment Trap

Why Republicans Can't Repeal Obama's Health Reform: Tea Party Take Note

2011-10-21T22:01:00.000-07:00

Rosemary Gibson: Why Republicans Can't Repeal Obama's Health Reform: Tea Party Take Note, Huffington Post, 10/21/2011

As the congressional super committee looks for $1.5 trillion in deficit reduction, Republicans on the Senate Finance Committee urged repeal of President Obama's health care reform, The Hill reporter Sam Baker wrote this week. The truth is that Republicans are playing a two-sided game over repeal. Here's how.

You'll remember that in February of this year, House Majority Leader John Boehner led Republicans in the House of Representatives to vote for the repeal of the health care reform law even though the Senate didn't have the votes to do the same. It made for a good show of solidarity with the Tea Party that had swept Republicans into office in the 2010 mid-term election.

But wait a minute. Why would Republicans want to repeal health care reform? Sure, they don't want to see Obama succeed on his signature domestic issue. But their natural allies, big health care businesses -- drug companies, device manufacturers, health insurance companies -- gained a whopping 32 million new customers beginning in 2014 with the stroke of Obama's pen on March 23, 2010.

What businesses would ever get that many new prospective customers - with government subsidies to boot? Even better, each customer will spend, on average about $8,000 a year on health care. The medical-industrial complex will divide the lucrative spoils. This means that another 32 million people are at risk of having unnecessary cancer-causing CT scans, open heart surgeries and stents and drugs which I wrote about in The Treatment Trap.

Los Angeles Times reporter, Norm Levy, reports that conservative experts think that if the GOP wants to dismantle the law, they need to replace it with something else. They'll need a replacement, too, if the US Supreme Court declares the individual mandate unconstitutional.

Are Republicans having a moment of compassion for people without health insurance? Hardly.
The truth is that Republicans face great peril if they succeed in repealing the reform law and denying the medical-industrial complex the hundreds of billions of dollars they expect in revenue from Obama's health care reform. Expect a big push back from an apoplectic industry.

Levy from the LA Times quotes Mary Grealy, president of the Healthcare Leadership Council, a coalition of executives of big health care industry companies, 'Wholesale repeal leaves you with nothing." That's right. Repeal of health care reform leaves the health care industry with nothing.

That's not an option for Republicans who have conspired with the big-moneyed health care interests whose bottom lines depend on the blind generosity of the American taxpayer.

Health care is still so lucrative now that private equity firms are jumping on the bandwagon and pouring money into health care with the expectation of profits in the next couple of years. See my earlier blog post:They want to get in, grab the money, and go before health reform's Independent Payment Advisory Board (IPAB) kicks in beginning in 2015. Maybe.

Republicans and the industry are targeting the IPAB and anything that gets in the way of them taking a larger share of America's income. The board acts like a circuit-breaker if Medicare spending shoots up too much in a given year. It's the only part of the health care reform that has a meaningful chance of making Medicare sustainable as the boomers reach their 80s and 90s.

Of course, the medical-industrial complex doesn't care about that. It claims that the board will allow government bureaucrats to get in between you and your doctor. Here's the truth.

Drug and device companies want to get in between you and your doctor so they can market every drug and device known to humankind right on your IPad and IPhone. This gives new meaning to direct-to-consumer advertising. People will succumb to all kinds of gimmicks -- treatments, tests and surgeries that can cause more harm than good.

Whatever happens, Wall Street-driven health care will find its way into your wallet.

Rosemary Gibson is the author of The Treatment Trap: How the Overuse of Unnecessary Medical Care is Wrecking Your Health

Read article on Huffington Post

Medicare Unveils New Online Patient Safety Ratings for Hospitals

2011-10-21T21:58:00.000-07:00

Medicare Unveils New Online Patient Safety Ratings for Hospitals - California Healthline (10/18/2011)

"...Medicare officials last week began publishing patient safety ratings for hospitals across the U.S. on CMS' Hospital Compare website, Kaiser Health News/MSNBC reports.

The data evaluate hospitals based on rates of surgical complications, infections, medical errors and potentially avoidable deaths. The website compares hospitals' ratings with national averages for medical complications and hospital-acquired conditions.

The ratings are part of an initiative mandated by the federal health reform law in which hospitals with the lowest quality ratings will receive lower Medicare reimbursements.

Patient Safety Advocates Commend Ratings
Patient safety advocates have praised the ratings.

Rosemary Gibson -- the editor of a series of articles on overtreatment in the Archives of Internal Medicine -- said, "This is pulling the curtain back on preventable health care harm to older Americans." She added, "These are really good things to know."

Read rest of article

Attention Wall Street Protestors: Wall Street is Messing With Your Health by Rosemary Gibson Cross-Posted from Huffington Post, 10/7/11

2011-10-18T10:15:00.000-07:00

Have cancer? Don't worry, Kohlberg and Company bought 16 outpatient cancer centers this year.

Live in Massachusetts and need to go to the hospital? No sweat, Cerberus Capital bought six Catholic hospitals that the Archdiocese of Boston had to sell in a fire sale.

Have a loved one who needs home health care? Check out the four largest publicly traded home health care companies that are in the crosshairs of the US Senate Finance Commitee for overtreating patients just to make a buck - Amedisys, LHC group, Gentiva, and Almost Family. If you think overtreatment doesn't matter, read The Treatment Trap for tips on how to avoid medical care that can cause you more harm than good.

Live in Detroit? Did you know that the Blackstone Group controls Vanguard Health Systems which bought the Detroit Medical Care System?

Have a loved one who is dying? No need to fear. They can get care from hospices owned by a private investment firm, Cressey and Company.

If Wall Street messed with your wealth, imagine how it is messing with your health.

Investor-owned, for-profit health care is determining the medical treatment you get.

It wants you and everyone else to be a patient every day and forever. In return, the investors run to the bank after billing you, your insurance, and Medicare.

In fact, you need to worry less about government bureaucrats getting in between you and your doctor, and more about Wall Street interests determining the treatment you get. Perish the thought.

The financial industry nearly brought the country to its knees. No worry there either. For-profit health care will replace them if they ache too much for too long.

Its tentacles reach into the homes all across America, on Maple Streets, Sycamore Avenues, and Grand Boulevards.

Their ideal patient is taking ten drugs that cost thousands of dollars a month; has repeat back surgeries that cost $80,000 each; and has cancer and goes to the doctor three times a week.

Wall Street needs you, me, and everyone to be sick so they can report ever-escalating stock prices and earnings per share. Don't have the money?

Charge it on your credit card. As for the federal government, no worry their either. It will just keep borrowing 40 cents for every dollar it spends. Thank you, China.

As for health reform, well, health insurance used to be about giving people access to providers. Now, it's about giving private equity firms access to people.

Rosemary Gibson is the author of The Treatment Trap: How the Overuse of Medical Care is Wrecking Your Health and What You Can Do To Prevent It.

Many hospitals overuse double CT scans, data show

2011-06-22T03:50:00.000-07:00

Many hospitals overuse double CT scans, data show - The Washington Post

By Julie Appleby and Jordan Rau
8/18/11 Washington Post

"...Experts say almost all chest problems can be properly diagnosed with a single scan. But some physicians who order the tests still value double scans for gathering the most information possible. Hospitals and radiologists are paid more for the double scans, so they have a disincentive to crack down on them.

“This is one of thousands of things we do every day in health care that cause more harm than good,” says Rosemary Gibson, co-author of “The Treatment Trap” and editor of a series of articles on overtreatment in the Archives of Internal Medicine.

Most hospitals used the double chest scans sparingly. The median rate was 2 percent of all Medicare patients who received chest scans, according to Hospital Compare data on 3,094 hospitals. But 618 hospitals performed the tests on at least 10 percent of Medicare patients getting a chest CT scan.

Ninety-four of those hospitals performed double scans on at least half their patients getting chest scans. The highest rates “really raise a red flag,” says Paul L. Molina, chief of chest imaging at the University of North Carolina School of Medicine."

Read rest of article

Sometimes, Less is More

2011-06-16T05:44:00.000-07:00

CROSS-POSTED FROM AUSTRALIA'S INSIDE STORY

BY MELISSA SWEET
A growing movement among US healthcare professionals is arguing that medical treatment can cause more harm than good, reports Melissa Sweet
http://inside.org.au/sometimes-less-is-more/

MOST of us have grown up listening to the constant refrain of modern healthcare: the chorus telling us that we should have more tests, more treatments and more interventions – for the sake of our health.

But another tune is increasing in volume, urging us to be alert to the potential for people to suffer harm as a result of over-diagnosis and unnecessary treatment. And it is probably no coincidence that the “less is more” riff is taking off in the home of what some call the “medical-industrial complex,” the United States.

Again, it is probably no coincidence that one of its powerful proponents, Rosemary Gibson, has long experience working in patient safety and palliative care policy. These are two areas where the harmful impacts of unnecessary interventions are particularly evident.

Gibson spoke recently at an Association of Health Care Journalists conference in Philadelphia about her experiences at the Robert Wood Johnson Foundation leading a national strategy to improve end-of-life care.

“When we started this work,” she says, “if you picked up a medical or nursing textbook you would never know that a human being ever died. If you never talked about the fact that people die in teaching, then people don’t know how to care.”

Gibson argues that one of the major obstacles to achieving a more humane and appropriate end-of-life care is treatment that causes more harm than good. Too often, she says, health care services and professionals don’t know when to stop. Clinicians are often “so busy doing”, she adds, that they don’t recognise the “burden of treatment… We have to respect nature – from that wonderful song, there is a time to be born and a time to die.”

It was when she was researching Wall of Silence: The Untold Story of the Medical Mistakes That Kill and Injure Millions of Americans, co-written with Janardan Prasad Singh and published in 2003, that Gibson began thinking about over-intervention. The book sought to put a human face on the landmark 1999 Institute of Medicine report, To Err is Human, which estimated that between 44,000 and 98,000 people die in US hospitals each year as a result of preventable medical errors.

Gibson says that the three critical dimensions to patient safety, as identified by the Institute of Medicine, are underuse, misuse and overuse. In 2010, she and Singh followed up with The Treatment Trap: How the Overuse of Medical Care Is Wrecking Your Health and What You Can Do to Prevent It, which offers policymakers and consumers suggestions for avoiding excessive healthcare. Many of the ideas in that book would resonate in the Australian healthcare system.

Apart from the potential for overuse to cause patient harm and waste, Gibson highlights the question of equity. “We’re providing unnecessary back surgeries on the one hand, when there are people in the US who can’t get proper dental care… It’s a complete misallocation of resources.”

Concerns like these are gaining increasing attention in the medical mainstream. In recent months Gibson has been editing a series for Archives of Internal Medicine titled “Less Is More,” which aims to help identify areas of medical care in which harm outweighs benefit. “Our goal is to educate patients, as well as their physicians, so that such medical care can be avoided in the interest of patient health and safety,” the journal said. Articles in the series have examined the harm caused by overuse of diagnostic imaging, proton pump inhibitors, and medicines in the elderly.

In one accompanying editorial, a group of medical researchers who have been at the forefront of “less is more” research, Lisa Schwartz, Steven Woloshin and H. Gilbert Welch (authors of a recent book, Overdiagnosed: Making People Sick in the Pursuit of Health), blame the daily barrage of medical news, public service announcements and advertising for pushing more testing and treatments. “The truth is, most patients would do better with less, not more, testing,” they write.

Another editorial drew attention to the forces driving overtreatment, many of which will be familiar to Australian audiences:

These include payment systems that reward procedures disproportionately compared with talking to patients, expectations of patients who equate testing and interventions with better care, the glamour of technology, the fact that it may be quicker to order a test or write a prescription than explain to a patient why they are not being treated, and of course, defensive medicine.

Another reason is “technology creep.” After a device is approved for use with a high-risk population in which there is a proven benefit, its use often expands to lower-risk groups in which the benefit does not outweigh the risk.

Meanwhile, the “less is more” chorus is pushing for more than a share of the airwaves; they want action.

The National Priorities Partnership, which represents a variety of US health groups and is convened by the National Quality Forum, has nominated overuse as one of its core priorities. It has identified a long list of overused interventions that it suggests should be targeted by health care services and providers, as well as information sheets to help members of the public avoid unnecessary interventions.

The interventions it suggests targeting include inappropriate antibiotic use, unnecessary laboratory tests, unwarranted maternity care interventions including caesarean sections, unwarranted diagnostic imaging procedures, inappropriate end-of-life interventions and unwarranted use of procedures such as spine surgery, hysterectomy and prostatectomies.

Given the juggernaut of interests that promote the use of such interventions, it is clear that Rosemary Gibson and other members of the “less is more” chorus have an almighty task ahead.

“It took us a long time to become a system where overuse is pervasive, and it will take a long time to dig ourselves out,” she says. “If we want a financially sustainable system, we have to start digging.” •

Melissa Sweet is a health journalist and editor of the health policy blog Croakey. She has honorary appointments in the School of Public Health at the University of Sydney and the School of Medicine at Notre Dame University (Sydney campus).

Sometimes, less is more | Inside Story

2011-06-16T05:21:00.000-07:00

Sometimes, less is more Inside Story

Medical Professionalism, Conserving Resources -- Just How Much is a Trillion Dollars?

2011-05-26T11:30:00.000-07:00

Cross-Posted from the Medical Professionalism blog of the American Board of Internal Medicine

by Rosemary Gibson

In recent weeks, headline news has been reporting on the battle to curb the federal debt. What does this have to do with medical professionalism?

The federal government must borrow forty cents of every dollar it spends. In health care, it needs to borrow from China and other lenders to reimburse doctors, hospitals and other providers who bill federal programs.

The government’s debt totals $14.3 trillion. It is hard to fathom how much money a trillion dollars is. Here’s one way to grasp the magnitude:

If I paid you, reader of this blog, $1 million every day since the year 1, or $1 million a day for 2,011 years, this would not tally to a trillion dollars. Multiply this by 14, and that’s how much debt the federal government owes its lenders.

Congress must vote in the next three months to raise the debt ceiling so the Treasury Department can borrow even more money – because the debt keeps growing. If it is not permitted to borrow more, the federal government will default and join the ranks of Greece, Portugal and Ireland. The U.K. avoided default by unprecedented cuts in government spending.

I applaud the American College of Physicians (ACP) for its statement earlier this year, “How Can Our Nation Conserve and Distribute Health Care Resources Effectively and Efficiently?”. Physician leadership is needed to help fix the unsustainable growth in health care spending so that patients’ interests are paramount.

The ACP said: “Physicians have… a responsibility to use health care resources wisely and responsibly. Resource allocation decisions also must be made at the national or systems level on how to control costs fairly and effectively for the health care system.”

I think that an important place to start is overtreatment. The National Priorities Partnership, convened by the National Quality Forum, identified areas of medical care that are overused.

By eliminating care that does not add to the health of patients, and which can cause more harm than good, precious resources can be used to help people live healthier, longer lives.

The future of our country depends on us digging ourselves out of this financial hole. We have no time – or money – to waste.

Go to: http://blog.abimfoundation.org/medical-professionalism-and-conserving-resources-%e2%80%93-just-how-much-is-a-trillion-dollars/#more-355

Cardiac Society Draws Bulk of Funding From Stent Makers

2011-05-14T11:52:00.000-07:00

by Charles Ornstein

Cross-posted from ProPublica, May 13, 2011

A poster for the Boston Scientific drug-coated stent at a conference in 2006. Boston Scientific is one of the biggest funders of the Society for Cardiac Angiography and Interventions. (Thomas S. England/Bloomberg via Getty Images)

A Pittsburgh hospital informed 141 patients earlier this year that they may have received unneeded angioplasties and stents, the tiny mesh tubes inserted to keep arteries open.

A Towson, Md., cardiologist faces a hearing on the fate of his medical license after being accused of implanting stents unnecessarily in more than 500 patients.

And this week, a new study found that more than half of patients with stable heart disease who received angioplasty and stents didn't first receive medications, as scientific guidelines recommend.

While a host of lawsuits and research studies has raised questions about the overuse of stents, the group that represents cardiologists who implant them relies heavily on income from the makers of these devices.

The Society for Cardiac Angiography and Interventions (SCAI)received 57 percent of its revenues in 2009 from medical device and pharmaceutical makers, according to financial information on the group's website.

Industry contributions to the society's budget covered $4.7 million of the $8.2 million it received that year.

The group's biggest funders are the companies with the biggest share of the stent market: Cordis Corp. (a subsidiary of Johnson & Johnson), Boston Scientific, Abbott Laboratories and Medtronic.

Read rest of article

Patient Safety Expert Says Law Could Lead To Overuse Of Medical Care: The KHN Interview - Kaiser Health News

2011-04-07T07:04:00.000-07:00

By Jordan Rau

KHN Staff Writer

APR 07, 2011

Cross-posted from Kaiser Health News

Over 16 years, Rosemary Gibson led national efforts to improve quality and safety in health care as a senior program officer at the Robert Wood Johnson Foundation. There, she was chief architect of the foundation’s strategy to establish palliative care in the mainstream of the U.S. health care system. She is principal author of "The Treatment Trap: How the Overuse of Medical Care Is Wrecking Your Health, and What You Can Do About It" (Ivan R. Dee, 2010). Gibson is now working on a book about health care reform.

She spoke recently with Kaiser Health News correspondent Jordan Rau. This is an edited version of her comments.

Q: Much of your work has focused on medical overuse, when the potential for harm from a health care service exceeds the possible benefit. How will the Affordable Care Act affect overuse?

A: Health insurance used to be about giving patients access to providers. That’s still true, but it is also about giving providers access to patients. The 32 million people estimated to be getting health insurance coverage when the law takes full effect will be exposed to overuse.

The health reform law also removes annual and lifetime caps. That can be an enormously valuable benefit to those who have a serious illness and need medical care; at the same time, it's an open invitation for health care providers, device manufacturers, pharmaceutical companies and every other health care business to increase volume and price. It's like a credit card without a credit limit. It's as if we have this tsunami, this surge of tests, procedures and medication. With health reform, we will be merely transferring the bankruptcy of individuals to the eventual bankruptcy of the federal government.

Q: You sure you want to use tsunami, given the deaths in Japan?

A: There’s an estimated 8,000 deaths from the tsunami, and that toll is certainly going to increase. It’s a terrible tragedy. The National Cancer Institute estimates there are 14,500 deaths every year from cancer because of radiation exposure associated with diagnostic imaging. That's just one example. In Japan at least they had a warning system; in U.S. health care we have no warning system about that potential harm of too much medical care.

Q: Proponents of the law have touted closing the so-called doughnut hole in Medicare Part D prescription drug coverage. Will that encourage overuse?

A: It's commonly known that so much medication use in the elderly is inappropriate and people can be harmed by it. The law certainly encourages the consumption of prescription drugs but without anybody to manage it. The health reform law has only an exceedingly modest tipping of the hat at geriatrics, but we have this huge growth in the number of people on Medicare as the baby boomers come on the program. There are very few physicians who are trained in the care of an older adult — the person who can manage this showering of medications on people. Just look at what Sen. Kent Conradsaid at the White House health care summit at Blair House: his father-in-law was on 16 medications near the end of his life. He contacted a physician who dramatically reduced the number of inappropriate drugs he was taking.

Q: What about parts of the law, such as creating accountable care organizations, that are intended to reward value rather than quantity?

A: The health reform law is supporting pilot projects to try different ways of paying for health care. It recognizes that fee-for-service is not sustainable. Those are very important efforts, but there’s going to be a long lag time between now and when we actually change payment.

Also, if we start paying on the basis of an episode of care — a set of services provided to manage a particular medical condition over a period of time — it depends on what level we set the payment. Will it build in and cement in the system the amount of overuse that already exists? Or, if it's set at a different level, it might provide some encouragement to reduce some overuse? The other issue that could come up is if we pay for episodes of care, suddenly we have a lot more episodes, particularly if we ratchet down the payment per episode. What we know in fee-for-service is if we reduce the payment per unit that creates the incentive to increase the volume.

Q: Would the Independent Payment Advisory Board make a difference?

A: That would be a way to at least draw a line in the sand and depoliticize it, like the process used for the military base closures. Because it would be geared to curbing growth in overall Medicare spending, that would be an enormous help. But every health care business sees that as an incursion into their revenue and they’ll call it government rationing.

Q: What would be the best approach to stop overuse?

A: Track the outcomes of patient care to learn whether what we do actually helps people. If a hospital wants to perform a back surgery, then that information has to be put into a registry and in real time we track outcomes. You combine that data with everybody else doing back surgery, you track the outcomes to find out if people are actually better off. That is the only way we’re going to make progress.

Q: Is there any movement to do that?

A: It was done with childhood cancer, which accounts for the progress being made in treating certain types. It’s being done in cystic fibrosis. In the pediatric world it's easier to do because there are smaller numbers and diseases are rarer, but this is where we need to go. You could start with a defined population. If states are concerned with the costs of their state employees' health care, let's have a registry for some of these procedures for state employees or people in workers compensation programs who have back surgery. The aim is to learn what's working and apply that knowledge in real time and stop doing what doesn’t work and causes more harm than good.

Cross-posted from Kaiser Health News

For more information on medical overuse, visit: www.TreatmentTrap.org

Hazards Seen in Medical OverUse (cross-posted from Modern Healthcare.com)

2011-03-24T15:33:00.000-07:00

Hazards seen in medical overuse

By Joe Carlson
Posted: March 24, 2011 - 4:15 pm ET
ModernHealthcare.com

"...A study published in the Archives of Internal Medicine two years ago concluded that as many as 29,000 cancers a year could be caused by the radiation from diagnostic imaging, and as many as 15,000 people actually die from cancers caused by it."

“Our minds have been marinated to believe more is better,” said Rosemary Gibson, an author of books on medical overuse and a section editor with the journal that published the study who spoke about the dangers of overutilization during a session on the last day of the American College of Healthcare Executives' annual Congress on Healthcare Leadership in Chicago.

“In many contexts, the mantra is volume, volume, volume. That certainly can drive overuse,” she said, highlighting a 2008 statement from the National Priorities Partnership that named four prime areas of medical overuse: medications such as antibiotics, C-sections, laboratory testing and diagnostic procedures.

Read rest of article

The Treatment Trap (March 2011 cable interview)

2011-03-21T13:13:00.000-07:00

Chuck Bell of Progressive News Network (White Plains, NY) interviews Rosemary Gibson, author of "The Treatment Trap: How the Overuse of Medical Care is Destroying Your Health, and What You Can Do to Prevent It."

Watch larger version of show on Blip TV

More info: http://www.treatmenttrap.org/

Consumer Reports Health Blog: Think twice about lap-band surgery for weight loss, By Rosemary Gibson

2011-03-05T16:12:00.000-08:00

It used to be that to undergo lap-band surgery, in which an inflatable silicon band is wrapped around the stomach to make it smaller and control the urge to eat, you had to be seriously obese. That meant having a body mass index (BMI) of 40 or higher, or a BMI of 35 or higher plus a serious weight-related health problem, such as diabetes. But the Food and Drug Administration recently relaxed those rules: People with BMI of 30 plus a weight-related health issue are now candidates.
The company that makes the band, Allergan, has video testimonials on its website from people who say they’ve had the surgery and tout its benefits.
It even a held a contest to give away a free surgery to three "lucky" winners.
Blogs advertise the surgery as if it were a luxury vacation—“All inclusive. We’ll beat or meet any advertised price! Only $3,999!”
But don’t rush to jump on the bandwagon. A closer look at the fine print reveals troubling risks. The firm’s own website reports a study that followed 299 people for three years after the surgery. Twenty-five percent of them had a second operation to remove the band.
That’s a lot of dissatisfied customers. Imagine if 25 percent of people who owned Toyotas were so dissatisfied that they called up their dealers and asked them to come and take their cars out of their driveways.
That’s not all. Nine percent needed a second operation to fix problems with the band. Nine percent needed an additional procedure to fix a leaking or twisted access port, a design issue that the manufacturer says has been improved. Four people had the band erode into their stomachs.
Less serious side effects are also common. Half the people who had the procedure reported nausea and vomiting. Thirty-four percent suffered from gastroesophageal reflux, 24 percent of people experienced band slippage (which might stem from excessive vomiting), and 14 percent developed stomach blockages.
For some people, lap-band and other related weight-loss procedures can be appropriate. But surgery—particularly one with known risks—should never be taken lightly. So before you consider it, make sure you’ve exhausted other proven ways to lose weight. And make sure you and your doctor have a thorough discussion about the potential risks of the surgery, and make sure that it’s right for you.
—Rosemary Gibson, author of “The Treatment Trap: How the Overuse of Medical Care is Wrecking Your Health and What You Can Do To Prevent It,” 2010.

Too much medical care can kill, author warns in Texas

2011-01-18T05:11:00.000-08:00

Too much medical care can kill, author warns in Texas
About one-third of health care spending is wasted, much of it on care that is unneccessary for patients but lucrative for doctors, author says.
By Mary Ann Roser

Austin AMERICAN-STATESMAN STAFF

Published: 11:40 p.m. Saturday, Jan. 15, 2011

A third of all people who have heart bypass surgery don't need it. Tens of thousands of people with chronic back pain have surgery each year despite almost no evidence it will help. And 300,000 women a year have their ovaries removed unnecessarily.

Those are just some of the ways Americans are overtreated by doctors — and often harmed in the process, according to Rosemary Gibson, co-author of "The Treatment Trap: How the Overuse of Medical Care Is Wrecking Your Health and What You Can Do to Prevent It." Gibson, section editor of the Archives of Internal Medicine, a scientific journal published by the American Medical Association, wrote the book with Janardan Prasad Singh, a World Bank economist .

Gibson was in Texas this month to speak to a national physicians conference in San Antonio. In an interview with the American-Statesman, she said she hopes the book serves as a warning to consumers to be more informed — and skeptical — about their medical care.

"The Treatment Trap" includes accounts from doctors, nurses, patients and family members who tell of harm and death from unnecessary and risky operations. Some women could no longer have babies because of unnecessary hysterectomies for fibroid tumors. People were treated for cancers they never had, and tens of thousands of children unnecessarily receive ear tubes each year to prevent infections.

Gibson, along with the Consumers Union's Safe Patient Project , is collecting patient stories of overtreatment online (www.treatmenttrap.org ). Many doctors do not overtreat, and even some who do don't see what they do as overtreatment; others are making big salaries at the expense of patients, she said.

Gibson cited the recent case of Baltimore cardiologist Dr. Mark Midei, accused of inserting multiple unnecessary heart stents, as deeply troubling. The Texas Medical Board has raised similar allegations against Dr. Samuel DeMaio of Austin, who is now practicing in El Paso. A board panel is scheduled to meet in mediation with him Jan. 31.

Read rest of article

The Senate Finance Committee and Unnecessary Cardiac Stents

2010-12-06T09:44:00.000-08:00

Today the Senate Finance Commitee released its scathing and incisive report on a Baltimore doctor, Mark Midei, and his relationship with Abbott who cheered his use of cardiac stents in nearly 600 patients who didn't need them.
http://finance.senate.gov/newsroom/chairman/release/?id=ce0c5525-b352-474f-9970-96f5afc140bb.

When the Baltimore Sun broke the story a while ago about the massive number of patients who had unnecessary surgeries, here is what the Vice President of Global Marketing for Abbott Vascular, David C. Pacitti, wrote to Abbott Divisional Vice President for Sales Sam L. Conaway: ‘‘Don’t you have connections in Baltimore????? Someone needs to take this writer outside and kick his ass! Do I need to send the Philly mob?’’

Health care reform does little to stop the onslaught of unnecessary surgeries. Sad to say but the public is on its own to avoid the treatment trap. Trust by verify. And read The Treatment Trap so you can avoid rampant overuse for profit. http://www.amazon.com/Treatment-Trap-Overuse-Medical-Wrecking/dp/1566638429

Here's a link to the NYT Story: http://www.nytimes.com/2010/12/06/health/06stent.html

Rosemary Gibson on Patient Safety at the NASHP Conference

2010-12-01T16:31:00.000-08:00

11/3 Conversations on Health Care Interview

2010-11-06T05:09:00.000-07:00

Community Heath Center Presents Conversations on Health Care

This Week’s Show: Rosemary Gibson, author of The Treatment Trap: How the Overuse of Medical Care is Wrecking Your Health and What You Can Do to Prevent It.

Conversations on Health Care focuses this week on patient safety. Mark Masselli and Margaret Flinter speak with Rosemary Gibson, nationally known for her work in patient safety, communications and healthcare quality. Her latest book, The Treatment Trap, focuses on the overuse of medical care and what can be done to reduce it.

Rosemary Gibson

Click here to listen to the interview

Interview transcript

Currently, Conversations on Health Care is featured on:
WESU, 88.1 FM based in Middletown, CT.
WNHU, 88.7 FM in West Haven, CT.
KRLX, 881. FM out of Northfield, MN.
Public Reality Radio, 1680 AM and 95.3 FM in Grand Rapids, MI.

What's Your Radiation Exposure? Read Consumer Reports Health Blog: Do you really need that X-ray or CT scan?

2010-10-07T17:14:00.000-07:00

Consumer Reports Health Blog by Rosemary Gibson, Guest Blogger: Do you really need that X-ray or CT scan?

Have you had an X-ray or CT-scan lately? The number of such scans has multiplied in recent years to some 70 million. And nearly a third of CT scans done in adults and a quarter of those in children are like to be inappropriate, according to a 2007 article in the New England Journal of Medicine. All that exposure translates into substantial risks. Researchers at the National Cancer Institute have estimated that 29,000 cancers could stem from CT scans performed in 2007, particularly of the abdomen, chest, head, and pelvis.

To help correct the problem, the Radiological Society of North America recently called for a new plan to limit and track radiation exposure from imaging tests. Until that system is in place, here are few things you can do:

1. Learn about the risks. Go to RadiologyInfo.org for details about radiation doses from common imaging tests.

2. Ask about alternatives. Before you undergo any imaging test involving X-rays, ask if it’s really necessary or if there are any alternatives. And make sure your doctor knows about other tests you have had, so you can both determine whether the risk of the additional exposure is worthwhile.

3. Avoid duplicate tests. Make sure that medical records travel with you to different departments and facilities, so that tests aren’t unnecessarily repeated.

—Rosemary Gibson, guest blogger

Rosemary is the author of "The Treatment Trap: How the Overuse of Medical Care is Wrecking Your Health and What You Can Do to Prevent It," Ivan R. Dee, publisher, 2010

Posted from: http://blogs.consumerreports.org/health/2010/10/imaging-tests-do-you-really-need-that-x-ray-or-ct-scan-.html

A Crucial Conversation That Can Change Your Life: See This New Film On YouTube

2010-09-27T07:05:00.000-07:00

In health care today, it's too easy to fall into the treatment trap. This is what happend to twenty-two year old Michael Skolnik of Colorado.

After suffering a seizure, a doctor recommended that Michael have a type of brain surgery that is a high-risk procedure. Michael was asked to consent to the surgery while he was under the influence of powerful medications prescribed by his doctor after the seizure. Michael's parents, Patty and David Skolnik, were not included in the conversation. Less-invasive treatment options were not discussed; neither were the risks and benefits. The doctor did not mention that a nearby hospital was better equipped to perform the surgery than the hospital where the operation was eventually performed.

Click on this link to see a five-minute film clip on YouTube: http://www.youtube.com/watch?v=CchN53SqzyI&feature=related. You'll learn about the importance of a crucial conversation that may change your life someday.

This riveting film was developed by two physicians who are leaders in patient safety, Dr. David Mayer and Dr. Tim McDonald, from the University of Illinois Medical Center in Chicago. It will premiere in Chicago on October 28, 2010.

New Jersey Doctor Forced to Retire: He Didn't Order Enough Tests

2010-09-14T10:00:00.000-07:00

Recently, I gave a lecture for medical grand rounds at St. Peter's University Hospital in New Brunswick, NJ. It's on C-Span's video library (http://www.c-spanvideo.org/program/294998-1). Afterwards, I received a letter from a physician who was in the audience. I called to thank him for the letter and he allowed me to quote him for this blog. I'll call him Dr. G.

This Ivy League educated ophthalmologist wrote with concern about the health care systen being "awash" in money. "I think the addition of multiple useless tests has increased the cost and harm to patients. I can't say enough about this," he wrote.  "We have known about these things in our profession for a very long time, yet nothing seems to be done about it."

Dr. G. mentioned a good friend of his, a cardiologist, who was "nudged into retirement because he didn't order enough tests on the equipment which his practice had purchased.... His loss is immeasurable; he was able to substitute good clinical judgment for a bevy of tests."

Dr. G. seems to be a very conscientious physician. He has had 4 major illneses and believes that experience is "the most valuable part of my training since it taught me the value of being a patient and the tremendous influence a doctors has over the course of an illness."

The good doctors are still out there. But I worry about them. I also worry about the patients of the doctors who drive out the good ones that practice medicine for the right reasons.

One of those patients was a colleague of mine, a scientist and researcher. She has had a heart murmur for years and closely monitored her condition.  As part of her watchful approach, she went to a diagnostic testing center, which happened to also be in New Jersey, and had a stress test.  When the test was completed, a young cardiologist said she needed to stop jogging right away, that she needed to be on a prescription drug, and she needed mitral valve surgery, an open-heart procedure.

My friend, the scientist, was devastated.   She talked about a family friend who had recently died on the operating room table during open heart surgery at a Philadelphia hospital.  Her doctor's recommendation for open heart surgery compelled the wife and mother of two children to contemplate her own mortality.

"You won't believe this," she said as she continued telling her story. She said that while she was on the treadmill, she overheard the doctor tell the nurse, "We're at 9 patients a day; we need to get to 14 so this place pays for itself." At that moment, she knew she wouldn't trust anything the doctor recommended. In fact, he wanted to do a cardiac catheterization right then. She had the wisdom to leave that place and never look back. She found a team of physicians who concluded that she should maintain watchful waiting. Three years later, she is doing well.

Dr. G. ended his letter this way, "Most of the people who come to see me want a good night's sleep or they want direct, honest, efficient care with a minimum of fuss." I think he's right.:

McStatins: British Researchers Recommend Free Statin Giveaway at McDonalds

2010-08-28T11:25:00.000-07:00

Here's the latest salvo to snare unsuspecting people into the treatment trap.

Researchers at Imperial College London are recommending that free statins be given to customers who order burgers, fries, and other artery-clogging food at fast food chains.

In the American Journal of Cardiology /www.ajconline.org/article/S0002-9149(10)00870-2/abstract#gs1, researchers say that taking a statin pill will reduce the risk of heart disease among people who eat fatty fast food, like a Quarter Pounder with cheese.

It's unbelieveable but the researchers say that taking a statin is a preventive measure similar to drivers wearing seatbelts. It is hard to fathom but they are seriously suggesting that small doses of powerful chemicals be given out to customers, free, when they pick up their order at the counter, like small packets of ketchup and relish. What about the side-effective of statins? No mention is made about them.

This idea should be dead on arrival. The British Heart Foundation funded the study. Surely there's better research to fund that would help people hooked on fast food.

8/14 & 15 >> The Treatment Trap on C-SPAN2 Book TV

2010-08-13T05:45:00.000-07:00

Click here to watch The Treatment Trap on C-SPAN2 Book TV

This weekend, C-SPAN2 Book TV airs a recent book talk by Rosemary Gibson, co-author of "The Treatment Trap: How the Overuse of Medical Care Is Wrecking Your Health and What You Can Do About It"

The talk will air on C-SPAN2 Book TV on:

Saturday, August 14th at 11:45am (ET)
Sunday, August 15th at 6:15pm (ET)

Rosemary Gibson argues that the overuse of medicine is an important contributor to the exploding cost of health care in the United States. She also says that many people have been negatively effected by undergoing unnecessary procedures. She spoke at University Hospital in New Brunswick, New Jersey.

About the Author: Rosemary Gibson

Rosemary Gibson, former senior program officer at the Robert Wood Johnson Foundation and former senior research associate at the American Enterprise Institute, is the co-author of "Wall of Silence: The Untold Story of the Medical Mistakes that Kill and Injure Millions of Americans.

Buy the author's book from:

Amazon Barnes & Noble Indiebound

Health Affairs: "Too Much Of A Good Thing Can Harm You"

2010-08-06T00:47:00.000-07:00

Too Much Of A Good Thing Can Harm You -- Gifford 29 (8): 1554 -- Health Affairs:
Health Affairs, 29, no. 8 (2010): 1554-1555

"...Norman Rockwell’s paintings had the unique ability to capture the spirit and principles that Americans have traditionally held dear. He frequently depicted the relationship between patient and physician, with the artwork reflecting the trust and value that we still award our physicians. After reading The Treatment Trap by Rosemary Gibson and Janardan Prasad Singh, I believe that Rockwell would not still be painting the same type of pictures today. Somehow those of us involved in health care have drifted away from the values he captured. We’ve forgotten that we entered the health professions to help people stay healthy and cure those who are sick..."

Read rest of review

Ear infections in kids: Think twice about surgery

2010-07-27T20:42:00.000-07:00

Cross-posted from: Consumer Reports Health Blog: Ear infections in kids: Think twice about surgery

July 26, 2010

Ear infections in kids: Think twice about surgery

Should you consider ear tubes for your child to prevent ear infections? Probably not, according to a study from researchers at New York’s Mount Sinai School of Medicine.
Nearly 670,000 children had tubes surgically inserted into their ears in 2006, making it the most common operation performed on children. But most children who have the surgery don't need it, according to the study, which was published in the British Medical Journal. Investigators who reviewed the records of 682 kids (average age was just under 4) who had the procedure concluded that about 70 percent of the operations performed were inappropriate, based on criteria created by an expert panel, as well as guidelines developed by the American Academy of Pediatrics, American Academy of Family Medicine, and the American Academy of Otolaryngology—Head and Neck Surgery.

And it’s not like the issue of overuse is new: 16 years ago, a study in the Journal of the American Medical Association found that more than half of the operations were not fully justified. The American Academy of Pediatrics says that surgery should generally be reserved for children who have fluid in the middle ear with persistent hearing loss or other signs and symptoms that last for several months.
The risks of surgery and anesthesia may be downplayed to avoid fear. Still, as parents, we need the facts to make an informed choice. Remember, too, that surgery isn't always a magic bullet. Children might still get ear infections afterward, and they might require repeat operations. So get the facts before choosing surgery. Your child—and you—will sleep more soundly.
—Rosemary Gibson, guest blogger

Rosemary is the author of "The Treatment Trap: How the Overuse of Medical Care is Wrecking Your Health and What You Can Do to Prevent It," Ivan R. Dee, publisher, 2010

Does your child get frequent ear infections? These tips can help prevent them.

PrimeTime Radio: Overused, Overtreated and Out of Control

2010-07-23T02:10:00.000-07:00

PrimeTime Radio: Overused, Over-treated and Out of Control - AARP

With healthcare in the national spotlight, Rosemary Gibson turns her focus on unnecessary surgery, needless x-rays and tests. Wasteful medical practices not only drive up healthcare costs, but can also be harmful to patients.

In The Treatment Trap Gibson urges patients to ask questions and take control of their healthcare. She has been a consultant for the Medical College of Virginia and the Virginia State Legislature’s Commission on Health Care.

Listen as Gibson discusses the dangers of wasteful medical practices with PrimeTime Radio host Mike Cuthbert.

Marketplace: Q & A about End of Life Care

2010-07-22T19:42:00.000-07:00

Questions and answers about end-of-life care | News In Brief | Marketplace from American Public Media

Posted by Caitlan Carroll on July 21, 2010 2:28 PM

"Today and yesterday on Marketplace, we ran a set of stories about end of life care. Yesterday, we looked at the economics of dying. Why is it so expensive? Do we get the care we want?"

"Today, we look specifically at palliative care. Palliative care is a relatively new specialty that’s gaining broader interest among the medical community. A lot of palliative care is geared toward people with terminal illnesses, but it can also be applied to those with chronic conditions. Palliative care helps people manage their symptoms and ease suffering...."

Read rest of post

MON, 7/26 5:00 PM Treatment Trap Book Signing in New Brunswick, NJ

2010-07-22T19:32:00.000-07:00

Author Rosemary Gibson will sign copies of her latest book, "The Treatment Trap," from 5 to 9 p.m. in the Sister Marie de Pazzi Conference Center at Saint Peter's University Hospital in New Brunswick. The cost of the book with autograph will be $20 at the event, which will also be broadcast on C-SPAN.

Gibson led national quality and safety initiatives at the Robert Wood Johnson Foundation for 16 years, and "The Treatment Trap" discusses how more medical care is not always better. Gibson also is the author of "Wall of Silence," which tells the story of the Institute of Medicine report "To Err is Human.

Click here for directions

cross-posted from: www.MyCentralNewJersey.com

4/17/10 Interview on Talkzone.com Internet Radio

2010-07-22T19:07:00.000-07:00

April 17, 2010 - The Treatment Trap

You’ve probably heard every angle on our nation’s healthcare system, and then some. But it might surprise you to find out too much medical treatment can be hazardous to your health. Then, speaking a different language can be valuable in the workplace. Now one expert says that includes the ability to translate between men and women.

Episode Segments:


InfoTrak: Unnecessary Medicine Healthcare expert Rosemary Gibson, author of The Treatment Trap: How the Overuse of Medical Care Is Wrecking Your Health and What You Can Do to Prevent It outlined what she believes is the most neglected issue in American medicine today: the overuse of medical care, including needless surgery and testing. She explained why the problems have become routine among many doctors, and offered ways that healthcare consumers can be sure they are getting appropriate care.

"The Treatment Trap" Reviewed in Oncology Times

2010-06-19T05:42:00.000-07:00

BOOK REVIEW: 'The Treatment Trap: How the Overuse of Medical... : Oncology Times

by Dr. Diane E. Meier MD

Oncology Times: 25 June 2010 - Volume 32 - Issue 12 - p 56

"...I thought I knew what there was to know about the overuse of medical care. I work in a big city tertiary care subspecialist-driven hospital. I am a geriatrician and a palliative medicine physician. I spend much of my clinical time trying to help patients and families make decisions that best fit their needs and goals among the ever-increasing range of treatment options offered to them. So I was surprised to find myself staying up late to finish thias book with a rising sense of despair at what has happened to our medical profession...."

"...The audience for this book is the general public. But we physicians should read it and reflect on what we may be risking. The reward and privilege of the practice of medicine depends entirely on trust—the fundamental priceless trust of our patients in our intent to do all in our considerable power to help them. Once the general public starts to believe that we could be using patients for purposes other than their own best interest—purposes such as increasing our volume to make money or to please hospital administrators; recommending treatments without a clear and honest explanation of the risks and the alternatives—we will lose the basis of our position and power to help.'"

"...The Treatment Trap is the canary in the mine for the medical profession."

Read rest of review

New America Foundation Blog About New "Share Your Story" Survey

2010-06-15T04:19:00.001-07:00

The New America Foundation's June 14 blog highlights the "Share Your Story" of overtreatment survey that was launched that day in partnership with TreatmentTrap.org and Consumer Union's Safe Patient Project. Check it out: http://health.newamerica.net/blogmain

Why are stories from consumers/patients important? I had a conversation recently with a progressive leader in an integrated health care system -- insurer + delivery system. She said that health insurance companies, hospitals and doctors won't be leading the charge on overtreatment. If they do, it will be perceived as rationing. Think "death panels".

Smart patients and consumers know better, and the stories coming in show that many of you are out there. Have you or a loved one had tests, surgeries, procedures or medications that you thought were unnecessary? Share your story. It can help others avoid the pitfalls and harm that can come from overtreatment.

Please click here to Share Your Story!

AP > Overtreated: More medical care isn't always better

2010-06-08T17:32:00.000-07:00

In this photo taken May 4, 2010, a CT is performed on a patient at Cook County Stroger Hospital in Chicago. Americans get the most medical radiation in the world, even more than folks in other rich countries. The U.S. accounts for half of the most advanced procedures that use radiation, and the average American's dose has grown sixfold over the last couple of decades. (AP Photo/Charles Rex Arbogast)

Overtreated: More medical care isn't always better | ajc.com:

By LAURAN NEERGAARD
The Associated Press

WASHINGTON — More medical care won't necessarily make you healthier — it may make you sicker. It's an idea that technology-loving Americans find hard to believe."

Anywhere from one-fifth to nearly one-third of the tests and treatments we get are estimated to be unnecessary, and avoidable care is costly in more ways than the bill: It may lead to dangerous side effects...

Read rest of article

New books show that the need to improve health care grows only greater

2010-05-18T05:17:00.000-07:00

New books show that the need to improve health care grows only greater

By Phillip Longman
Washington Post

Tuesday, May 18, 2010
THE TREATMENT TRAP

How the Overuse of Medical Care Is Wrecking Your Health and What You Can Do to Prevent It

By Rosemary Gibson and Janardan Prad Singh
Ivan R. Dee, 237 pages, $24.95

Amid all the cheering and jeering over the health-reform legislation recently signed into law, there remains one sober fact about our medical system that every American ignores at his or her peril: Contact with the health-care system remains one of the leading causes of death in the United States. The most recent confirmation comes from a new study from the independent ratings company Health Grades, which found that between 2006 and 2008, nearly 100,000 Medicare patients died due to medical errors.

With tens of millions of currently uninsured Americans now promised greater access to care, the urgency of reforming the practice of medicine, as opposed to its financing, has never been greater. This makes the two books reviewed here particularly relevant, whether you are an individual trying to navigate though the increasingly dangerous and dysfunctional health-care delivery system or a policymaker trying to figure out what's gone wrong and how to fix it.

"The Treatment Trap" is co-authored by Rosemary Gibson, who long worked at the Robert Wood Johnson Foundation on health-care quality and safety issues, and by Janardan Prad Singh, an economist at the World Bank whose previous work has concentrated on the same area. Together, they have produced a well-told, well-researched catalog of horrors about people killed and maimed by tests and operations they didn't need...

Read rest of review

Share Your Medical Overtreatment Story

2010-05-17T07:24:00.000-07:00

Q Have you or a loved one had tests, surgeries, procedures or medications that you thought were unnecessary?

If so, Consumers Union's Safe Patient Project, and Rosemary Gibson, co-author of the Treatment Trap, would like to hear your story. We'd also like to know if you declined tests or treatments offered to you that you thought were unnecessary and found a medically appropriate alternative.

Please click here to Share Your Story.

A Leading Journal Spotlights Medicines Many Patients Don't Need - ABC News

2010-05-16T04:22:00.000-07:00

A Leading Journal Spotlights Medicines Many Patients Don't Need - ABC News:

By JOSEPH BROWNSTEIN
ABC News Medical Unit
May 12, 2010

"Plenty of Hollywood dramas have a patient come in to a hospital for one problem, and in the course of their testing doctors find something horribly wrong -- cancer, for instance -- with that seemingly unnecessary test being the difference between life and death.

New research questions if radiation-based medical tests are worth the risk.
The story has appeal, but now a journal published by the American Medical Association is taking steps to highlight the perils of assuming that extra tests and treatments are always a good thing. Editors hope to spotlight the fact that those extra tests can often lead to unnecessary treatments or even hurt the patient..."

Read rest of article

Cleveland Doctor Terminated from Hospital for Failing to Meet Revenue Targets

2010-04-30T12:37:00.000-07:00

Today was Dr. George Randt's last day taking care of patients in Cleveland, Ohio. They cried, and he cried.

Dr. Randt is a primary care physician who has taken care of many patients, many of whom are in their 70s and 80s. His contract was terminated by St. John's Hospital. He says, "I was terminated because of lack of productivity. We weren't seeing enough patients."

His termination illustrates how patients have become a means to an end, and that end is the financial bottom line.

According to Dr. Randt, the chief financial officer of the hospital told a medical staff meeting a few months ago that if all the doctors could admit one more Medicare patient a month, the hospital would meet its revenue targets. "This suggests we should go out and commit fraud," Dr. Randt said.

"It's unconscionable," Dr. Randt continued. "I try to keep patients out of the hospital who don't need to be there."

He recalled two of his patients who doctors wanted to admit to the hospital. Dr. Randt intervened. Because he knew the patients' medical histories and took the time to talk to them, he helped them avoid the treatment trap and being admitted to the hospital.

"Patients are being overtested and overtreated," he said of patients. "It only creates more anxiety for them."

Dr. Randt was informed on March 31, 2010 that his contract to provide care to 1,000 of his patients, would end today. A partner in his practice who takes care of 1,500 patients, is also being terminated.

"I received bonuses in December 2008 and 2009," Dr. Randt says. "This suggests that we were generating a profit. I guess it wasn't enough."

On Sunday, May 2, a rally is being held at 29000 Center Ridge Road, Westlake, Ohio. Patients, family members, former staff members and others will speak at the rally.

"People should be out in the street protesting about the adverse effects of medicine driven by money," he said.

Patients ARE Saying No: Response to David Leonhardt's the "Power of No"

2010-04-07T09:04:00.000-07:00

David Leonhardt's NYT article today asks, "How can we learn to say no?" to unnecessary medical treatment. Here's the unvarnished truth. People already are saying no. In droves. They are finding medically appropriate, less invasive and costly approaches.

Last month, at a National Quality Forum meeting, I asked the health care leaders assembled, "Have you said "no" to treatment recommendations you thought were unnecessary? About one-third of the hands went up. This is a savvy group that understands the "power of no".

Here's a few true stories. At an AARP meeting a few months ago in Princeton, New Jersey, a woman described how her doctor said she needed an angioplasty. A second opinion revealed she didn't need it. The same was true for a woman who was told she needed a cardiac catheterization. The list goes on all over the country. Policy makers are not immune. A legislator was suprised to learn he needed a hernia operation. A second opinion revealed he was just fine.

A large swath of the public is more enlightened than policy makers and pundits know. Let's bring them into the policy dialogue. They can shed light on a way out of a financially unsustainable health care system while improving quality at the same time. That's a twofer too good to pass up.

Boston Globe: Taking Care with Treatment

2010-03-08T03:25:00.000-08:00

ROSEMARY GIBSON | G FORCE

Taking care with treatment

The Boston Globe, March 8, 2010

ELIZABETH COONEY

Author Rosemary Gibson says when medical care is overused, it can cost patients their health and their savings.

"Rosemary Gibson once led a successful national initiative to make palliative care more available to seriously ill patients. Now she has turned her attention to the overuse of medical care and how it can hurt patients as well as drive up health care costs. She will speak about her new book, “The Treatment Trap,’’ at noon tomorrow, at Health Care for All in Boston. In a telephone interview last week, she explained what consumers can do to avoid care that is not only unnecessary, but potentially harmful."

Q. How do you define “overuse’’?

A. Overuse is when the possibility of harm exceeds the possible benefits.

Q. Why is it so important now?

A. Just about everybody’s concerned about how we’re going to take care of whole families and not really break the bank, so a good way is to stop doing these things that cause more harm than good. The cost of overuse, as important as that is, I don’t think is sufficient to motivate us to begin to address it. I believe we have to go look at the impact on patients.

Q. Could you give an example of overuse?

A. We have a narrative from a patient who was one of many patients in California who had heart bypass surgery. Told he had a “widow maker,’’ he had immediate surgery. A year later, he learned he was one of a number of people who had heart procedures when it wasn’t medically indicated.

Q. Don’t Americans usually want more, not fewer, tests and treatments?

A. It’s fair to say that Americans, writ large, believe that more care is always better care. I think there also is the recognition that at some point there are diminishing returns from medical care. If we hear it from insurance companies or politicians, we’ll think it is rationing. But if we hear it from our peers, then it will come across differently.

Q. Aren’t patients and doctors afraid of doing less?

A. Physicians will do extra tests to make sure they don’t get sued, [a fear that is] very legitimate. And there’s the peer factor: If I’m a [specialist] and a primary care practitioner referred a patient to me for a workup, they expect I will do that workup. Combine this with the financial incentives of medicine: The more we do, the more we get paid.

Q. What can a patient do?

A. A patient should know that there are many fine physicians who will do the right thing by them. . . . We encourage people to be aware of the marketing glitz and to realize marketing is no substitute for information about the treatment options and the benefits and risks. They should ask about the risks. It’s important for them to be aware of why they are having the procedure, what it’s going to do for them, and what the evidence is for it.

To attend tomorrow’s talk at Health Care for All, 30 Winter St., e-mail Deb Wachenheim: dwachenheim@hcfama.org.

Interview has been condensed and edited.

www.TreatmentTrap.org

3/9 TUES > Event at Health Care for All in Boston, MA

2010-03-02T17:40:00.000-08:00

Event at HCFA Next Week on Overuse of Medical Care:

Health Care For All is hosting a talk next week by Rosemary Gibson, author of a new book titled “The Treatment Trap.”

The focus of the book and her talk will be on the overuse of medical care and how it is harming consumers as well as the health care system. The event is free and open to the public.

Join us on Tuesday, March 9, 12:00-1:00pm, at Health Care For All, 30 Winter Street, Boston, 9th floor. Please RSVP to Deb Wachenheim at dwachenheim [at] hcfama.org.

-Deborah W. Wachenheim

Senators launch fraud inquiry of Maryland Hospital

2010-02-22T05:22:00.000-08:00

Senators launch fraud inquiry of Md. hospital - baltimoresun.com:
St. Joseph records sought; probe spurred by report of unneeded stents

By Robert Little
February 20, 2010

"Federal lawmakers have asked St. Joseph Medical Center to turn over three years of billing records and other documents related to cardiac care, saying they are troubled by reports of unnecessary coronary stents implanted at the Towson hospital and want to investigate for signs of Medicare fraud."

"Montana Sen. Max Baucus and Iowa Sen. Charles E. Grassley - the top Democrat and senior Republican, respectively, on the Senate Finance Committee - also asked the hospital for records of its financial relationship with manufacturers of the medical devices. They set a March 12 deadline, saying their committee was launching an inquiry as part of its role 'to protect taxpayer dollars from waste, fraud and abuse...'"

Read rest of article

High-Tech Medicine Contributes To High-Cost Health Care - Kaiser Health News

2010-02-16T04:57:00.000-08:00

High-Tech Medicine Contributes To High-Cost Health Care - Kaiser Health News:

By Merrill Goozner, The Fiscal Times

FEB 15, 2010

"....The U.S. Preventive Services Task Force recommends against routine imaging screening for heart disease in healthy people like Kelley because many of those scans show false positives, sending people for further tests and procedures that needlessly drive up health care costs. CT scans also heighten one’s cancer risk because of high radiation levels. "

"Even so, the tests have proliferated in the half decade since advanced CT scanning machines hit the market. Since 2001, the number of scanning machines in the U.S. has increased by over 20 percent, while the number of scans taken each year has gone from one for every seven persons to almost one for every four. Yet there’s no evidence that the additional invasive procedures that result from this large increase in screening are preventing serious heart disease."

Read rest of article

Have You Had Medical Care You Thought Was Unnecessary? Share Your Story

2010-02-12T11:41:00.000-08:00

cross-posted from Disruptive Women in Health Care
www.disruptivewomen.net

Have You Had Medical Care You Thought Was Unnecessary? Share Your Story
By Rosemary Gibson February 11th, 2010

One-third of Americans say they have received tests, treatment or medications they didn’t need, according to a survey conducted for the Commonwealth Fund of New York. Are you one of them?

Think about it. We live in a market-driven economy where businesses thrive on getting us to consume more than we need, whether it’s a house that’s too big, a mortgage that’s unaffordable, or an investment that promises more than it can deliver. Market-driven health care is motivated by the same imperative. In our highly-caffeinated health care system, the mantra is volume, volume, volume. That ‘volume’ is you and me, and the people we love.

Here’s a story about a colleague, a research scientist, who has a heart condition that she watches very carefully. She went for a nuclear stress test at a free-standing diagnostic testing center as part of her routine monitoring. After the test was complete, the cardiologist told her she had a very serious problem that required open-heart surgery. She was scared out of her wits and immediately thought of a family friend who had died recently during heart surgery. The cardiologist wanted to do a cardiac catheterization and prescribe medication. He also told her to stop jogging immediately.

My savvy friend knew she didn’t want to have more tests or treatment at that center. Here’s why. While on the treadmill, she overheard the doctor tell the nurse that the center had nine patients a day and needed to increase its census to fourteen a day to generate enough revenue to make it financially viable. It’s true. She walked out and never looked back. A second opinion from expert physicians recommended continued monitoring and she followed their advice.
About ten years ago, the Institute of Medicine of the National Academy of Sciences convened a group of experts who acknowledged a uniquely American phenomenon in health care: overuse. It occurs when the possibility of harm exceeds the possible benefit. Health care insiders say that overuse is an epidemic. Epidemics are not good for anyone.

To learn what you can do to avoid unnecessary medical treatment, check out my new book coming out next month, The Treatment Trap, which has twenty smart steps for consumers. Read the foreword by Jim Guest, president of Consumers Union.

In the meantime, share your story about medical overuse by emailing it to:

TreatmentTrap [at] gmail.org

Together we can learn from – and empower – each other.

Stop Running Red Lights AND Pay for Health Care Reform

2010-02-02T19:08:00.000-08:00

Stop Running Red Lights AND Pay for Health Care Reform
by Rosemary Gibson
Cross posted from: Disruptive Women in Health Care
Sunday, February 1, 2010

"With all the hand wringing about health care costs, it is possible to cut costs without harming patients. Even better, costs can be reduced while making patients better off. Here’s how."

"An unspoken truth is that three kinds of medical treatment are provided in the U.S. The first is treatment whose benefit is unquestionable. Surgery to treat a ruptured appendix is an example. Without it, death from life-threatening infection is almost certain. The life-saving medical care being rendered to earthquake victims in Haiti is in this category."

"A second type of treatment is provided when uncertainty exists about benefits and risks. Doctors and their patients must balance the benefits and risks. The recent mammogram controversy fits into this gray zone."

"The third type of treatment is when the possibility of harm exceeds the possible benefit. A panel convened by the Institute of Medicine years ago called it “overuse”. This is the subject of my new book, The Treatment Trap."

"Health care tests and treatments today are like the colors of a traffic light. Life-saving treatments flash green. Where uncertainty exists, the light flashes yellow. With overuse, the light flashes red and tells us to stop..."

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Do You Care About Your Health? Then You Need to Read 'The Treatment Trap'

2010-01-31T10:41:00.001-08:00

With health care reform a prime objective of the Obama administration, the subject matter of The Treatment Trap is a compelling component in the national debate. Taking advantage of Rosemary Gibson's knowledge gleaned from extended experience in the field of medical care and Janardan Singh's similar knowledge but from a financial perspective, the authors explore the most neglected issue in American medicine today: the overuse of medical care, including needless surgery and other invasive procedures, out-of-control x-ray imaging, profligate testing, and other wasteful practices that have become routine among too many American doctors. Their combined reporting and analysis concentrates on the human aspects of this disturbing trend in health care, with personal experiences that reflect poorly on hospitals as well as physicians. They show how money spent for questionable and even useless care is diverting major funds that could be better used to treat patients who are genuinely sick and sometimes cannot afford the extravagant charges of the American health-care system. Their suggestions for reforming the delivery of health care, and their cautions to individual consumers about how to deal with situations they may encounter, make The Treatment Trap essential reading for medical care consumers, health-care professionals, and policymakers alike.

Publishers Weekly: "A Welcome Guide" for Patients

2010-01-31T07:10:00.000-08:00

Great Publishers Weekly review of the book: "Here's a book that might do more than health reform to get readers to question doctors' recommendations . . . offer[s] tales of patients who have been horrifically - sometimes fatally - ill-advised by doctors to have unnecessary medical procedures with unexpected complications. . ."

The authors cite experts who say the problem is systemic - doctors get paid for procedures - but suggest that patients can protect themselves by becoming informed consumers . . . A welcome guide in a process that too often depends on a patient's leap of faith."

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What People Are Saying about "The Treatment Trap"

2010-01-31T05:52:00.000-08:00

Applause for The Treatment Trap: How the Overuse of Medical Care Is Wrecking Your Health and What You Can Do to Prevent It by Rosemary Gibson and Janardan Prasad Singh

"A wake-up call for Americans." -- Dr. Christine Cassel, President, American Board of Internal Medicine

"This is a 'buyer beware' book for prospective medical care consumers. The examples of patient harm are individually important: together they create a tapestry of practice patterns that should give you the courage to constructively challenge the recommendations you get from your doctor." -- Paul O'Neill, former U.S. Treasury Secretary

"Combining facts with compelling stories, Rosemary Gibson and Janardan Singh put a human face on the shameful statistics of unnecessary medical care. But, more than just an expose, The Treatment Trap challenges the core of medical professionalism: putting the patient's interest first." -- Lucian Leape, M.D., Adjunct Professor, Harvard School of Public Health

"This book vividly depicts many of the ways in which health services are overused in the current health-care system at a time when candor, transparency and thoughtfulness are most needed. We will not achieve meaningful or lasting health reform until we solve the overuse problem." -- Mark R. Chassin, M.D., President, The Joint Commission

"Gibson and Singh have done us all a great service. The Treatment Trap is a frank account of what can happen if we assume that more treatment is always better. The good news is that patients can take steps to avoid becoming victims." -- Marjorie Ginsberg, Executive Director, Center for Healthcare Decisions

"The book is a must-read for Congress and the White House. The authors show that we are paying a steep price for overtreating patients." -- Margaret O'Kane, President, National Committee for Quality Assurance

"A powerful, poignant, apolitical and sobering must-read." -- Jennse Chin Hansen, R.N., former CEO/Executive Director, On Lok Senior Health Care Services

"Patients and consumers are woefully uninformed about the epidemic of overtreatment that is part and parcel of health care today. By exposing the human suffering and huge cost of unnecessary care, this book challenges everyone. It warrants serious reading and focused attention. -- Gerry Shea, Assistant to the President, AFL-CIO

"Gibson and Singh are courageous messengers who bring a light side of health care that has long been kept in the darkness. It is a wake-up call for consumers and health-care providers alike." -- Connie Barden, R.N., Past President, American Association of Critical Care Nurses