Once again, studies have shown that physicians tend to make clinical decisions for patients based on how much they are paid themselves.
In 2007, we learned from the Trial of Courage that angioplasty and stents (cutaneous coronary intervention (PCI)) do not reduce the risk of death or heart attack, but the patient does not seem to have taken notes. Only 1% recognize that there is no mortality or a heart attack benefit, probably because most cardiologists don’t mention that fact. You can imagine that if a patient understands that “there is no benefit of additional mortality,” rather than actually obtaining symptomatic relief, then he is less likely to go under the knife. Then, 10 years later, Orbita’s trial was published, and even the promise of relieving symptoms was an illusion.
“The meaning of Orbita is profound and broad. First and foremost, Orbita’s results clearly show that there is no benefit to PCI compared to stable angina medical therapy,” meaning heart disease. Essentially, patients “cannot do harm without benefits. It is difficult to imagine a scenario in which a fully informed patient chooses additional invasive treatment without additional benefits.” Remember the stent consent form previously explained. 1:17 in the video as shown below
Now it looks like this and can be seen below and at 1:21.
So, is Orbita’s test “final nails of PCI with stable angina pectoris?” So what about stents in non-urgent situations? The Journal Cardiovascular Journal of Revascularization Medicine did not point to “relief of widespread angina pectoris that occurred in both arms.” In other words, the stent helped, even if sphasing without a stent was just as helpful. So, “If a patient is treated with PCI and is benefiting from the ‘placebo effect’, who will interfere with the ‘treasury’ benefits? “If that’s the case, why not try a fake surgery? Placement of the stent costs around $40,000. It would be cheaper to fake everything. The reason we shouldn’t continue to stent people selectively is because our bodies are counting. During stent placement, 2% of patients develop bleeding or vascular injury, while an additional 1% die or suffer a heart attack or stroke. And 3% of patients are taking bleeding events from thin blood intake because something is stuck in their chest. Alternatively, the blood thinner will not work and the stent will coagulate and cause a heart attack.
Not only does we have no evidence of profit, but in many cases, “proof of profitlessness” is clearly stated, why are they still being done? One of the causes of resistance is all financial gains. These steps will make a lot of money to the hospital. Don’t expect them to “start to promote lifestyle changes to combat heart disease, nor do doctors support their income and not immediately abandon practices that they think make sense.” Is that easy? The famous Upton Sinclair quote is, “it’s hard to make a man understand something when his salary depends on him not understanding it” Do you think that’s just ironic? Ask the doctor yourself.
Thousands of doctors were surveyed, with 70% “that they thought doctors would provide unnecessary procedures when they benefit from them.” That’s what the doctors themselves believe. And the data is responsible for this. Physicians have been shown to make clinical decisions for patients based on the amount they pay. For example, if you choose chemotherapy to treat breast cancer, increasing your doctor’s margin by 10% could increase your chances of choosing one drug over another by up to 177%.
That is why the caesarean section may be “more likely to be done by a for-profit hospital compared to a non-profit hospital.” “Operating the Committee.” Paying the surgeon for each procedure can increase the surgical rate by 78%. Can that explain why we have 101% more angiogenesis than any other country? A study on “Practitioner Financial Incentives and Treatment Choice in Heart Attack Management” found that they actually “respond to the payments they receive and the response is very large… Unconditionally, planning to pay more doctors for more invasive treatments seems likely to lead to more invasive treatments. So, in reality, it may be very common for patients to receive different treatments based on whether the doctor is paid per procedure or not.
One of my heroes, Dr. Caldwell Esselstyn, is always trying to see the best of people, but he is trying to acknowledge that compensation may play a role. Evidence has emerged that doctors like Mark Miday, who inserted 30 stents in a day, “docs increased their medical costs by providing unnecessary stent implants.” That could be a claim worth about $1 million. As a symbol of gratitude, sales representatives at the stent company spent over $2,000 to buy “smoking pigs, peach cobblers, and other fixtures for barbecue dinners at Dr. Miday’s home.”
“The United States is the only developed country where healthcare is provided per service, and we are very free to encourage physicians to carry out invasive procedures,” explained the Cleveland Clinic’s Chief of Cardiovascular Medicine. “The economic incentives are too strong.”
