Where's the rank and file physician leadership? The Story Behind the Story
The New York Times recently ran a front page story about the Senate Finance Committee's ongoing investigation of an interventional cardiologist in the Baltimore area. This cardiologist, among other allegations, is being questioned about the appropriateness of inserting 30 intracardiac stents in a single day. THIRTY STENTS IN A DAY!!!!
In their investigation the Finance Committee has discovered evidence that many of this physician's procedures were not medically necessary...DUH!
But wait, this soap opera is not over. It turns out that this interventionalist was recruited by the hospital in which he worked, from the group he himself founded by a seven figure salary. His premium salary apparently was not based on superior medical judgement. But this lurid card was trumped by the president-elect of the Society of Cardiovascular Angiography and Intervention. When asked for a comment from the Times, he responded that "inappropriate stenting was a problem, but a rare one". The 3.6 billion bucks a year Medicare spends on stenting does not stop on his desk.
This story is really a story about the total ineffectiveness of today's medical leadership. Where was the CMO, VPMA, Director of Cardiology, and Cath Lab Director during this eveloving scandal. Who was safegaurding the quality of care delivered? Why was the behavior of this "cowboy" not addressed by them insead of the Federal Government, The New York times and some soon to be wealthier ambulance chasers?
Why didn't the president-elect of SCAI make the following statement to the times? "The allegations, if true, are an outrage and are unacceptable. I will take personal responsibility to learn from this unfortunate episode and make sure we develop protocols that will assue this will not happen again".
We need to invest in the training of physician leaders who embrace accountability and transparency, who are committed to consistent and demonstrable excellence in healthcare delivery, and most importantly master the skill set to be effective.
The consequences of our failure to train such leaders will be further loss of public confidence, more external regulation and review, wealthier personal injury lawyers supported by increases in our malpractice premiums and, most tragically, inconsistent suboptimal outcomes for our patients.