Monday, 30 June 2014

Cardiologists accused of overusing coronary stents for profit

by Michael Woodhead
One of the top stories in China's national Xinhua news site today concerns the case of a man who had nine coronary stents implanted at a cost of 150,000 yuan (US$24,000) for one operation. 
His family say they were shocked to hear of the number of stents - especially as the 58-year old man with blocked coronary arteries did not feel any better after the operation.  The accused the hospital authorities of Chifeng in Inner Mongolian of blatant 'overtreatment' and profiteering. A Xinhua reporter quoted the family as saying their father went in for an operation and was found to have extensive coronary artery blockage - the surgeons then recommended coronary stents, which they said would be better than a bypass grafting operation. However after the implanted six stents they told the family the man would need three more to complete the procedure, otherwise the first six would be wasted. 
The family agreed. but were amazed when they received the final bill for 150,000 yuan. They said they had not expected such a high bill and would have to borrow a lot of money to pay the medical fees.
The Xinhua reporter quoted other health authorities as saying that some cardiologists were abusing the system and overusing stents  because they got a high commission for each one implanted. Each stent cost up to 20,000 yuan and a doctor might get 2000 commission. An internet search of the term 'stent abuse' revealed that many families were making complaints online about having to pay large sums of money for multiple stent insertions. A spokesman for the hospital said it was sometimes necessary to insert multiple stents for one patient, and this was the clinical decision of the surgeon - there was no set rule or guidelines.  However, other medical experts said it was usual only to have one or two stents in a cardiac operation, and some hospitals had a rule that operations that required more than three stents had to be discussed with other surgeons and informed consent obtained form the patient and the family. The academic said that 12% of stent operations involved overtreatment and 38% of procedures are of questionable necessity.

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