That lesson influenced a lot of doctors from my generation, who saw all this happen early in our careers, but lessons that dont quite fit with personal ego and ambition have a tendency to be forgotten after a while, especially by younger people who did not see the events first hand. He accepts multiple insurance plans. Dr. Samin Sharma, MD has a star rating of 4.0/5. The business address is 20 Castle Walk, Scarsdale, NY 10583-3221. How likely are you to recommend Dr. Sharma? I was put on maximum medical therapy after the surgery and have been on it ever since. This provider has 21 years of experience and is affiliated with Catholic But hospitals cant bill $12,000 for deciding not to implant a stent, even if thats the best thing for the patient.. In addition, of course, doctors are subject to investigation and censure by their hospitals, potentially leading to loss of privileges (the right to work in the hospital) or other lesser sanctions, and by state medical boards, potentially leading to loss of license or other lesser sanctions. Please note: Interactive Pulse Extra is best viewed in a browser such as Google Chrome or Mozilla Firefox. ACOs certainly have the potential to do a better job with care coordination, especially if decent electronic records are in place and used. 2- Mo was president of Mount Sinai Brooklyn until mid 2018 and then transitioned to a role as executive vice president. We are being enormously group-stupid in not bringing the roof down on the bad boys of medicine. center, Health doctor, Find Still, there are ways stop them. Hello, I got over to your post via Reddit. stent procedures offer relief from the pain of angina for a whilebut not forever. Dr Samin Sharma And what about hospital administrators? he asks. Some physicians remain clearly undeterred by the research. Dr Samin Sharma health, Hepatitis "The surprising Dutch finding raises questions over how to handle the estimated 1.5 million Americans annually who have small heart attacks the most common kind. Samin Sharma | UT Health San Antonio Practice Locations. I think its encouraging that doctors may be starting to perceive greater litigation risk from doing this procedure as opposed to not doing it. ), The problem is this, he concludes, as long as the cardiologist reading the cath is the one who pulls the trigger on the intervention, we have a potential Fox/Henhouse problem., What may be most troubling about the Medei imbroglio is that it highlights how our infatuation with high-tech medicine tempts us to ignore medical evidence. run 75441- Samin Sharma, MD, is a specialist in internal medicine who treats patients in San Antonio, TX. Finally, most patients (and even many physicians) tend to assume that, when it comes to medical technologies, newer means better. This is why, when asked to participate in a randomized clinical trial, some patients refuse, fearing that they will miss out on receiving what they assume is the newer, better product. health. Copyright 2021. Medicare wants to put hospitals under some fianncial pressure because MedPAC reserach shows that when hospitals are under financial pressure, they learn to become more efficientand, in fact, beginning making a profit on those Medicare reimbursements. He put two stents in almost immediately, said one grateful patient. & consultants, Life to prove intent, or whether there are cases where criminal negligence could put a doctor in jail. If the docs in other countries perceive, correctly, that, as a practical matter, they are unlikely to ever be sued, even if the screening results are positive, the patient may not be sent to the cath lab if he/she is non-symptomatic or has stable angina. The popularity of stents is all part of a mindset that Drs. Dr. Sharma served on the Cardiac Advisory Board of New York State from 2004-2016, which advises the Health Department and the Governor on issues of health policies and supervision, safety, and appropriateness of heart care by various hospitals in New York. (Oh yeah, except for the ones regarding professionalism. Instead, when payers, including commercial payers as well as Medicare and Medicaid notice that a particular doctor and/or hospital is performing an unusually large number of procedures of any type, timely unannounced post-procedure audits should be performed by experts hired and paid for by the payers. I have been researching, investigating, speaking & writing on the ugly reality of physician misbehavior for more than a decade. I had quintuple bypass surgery in 1999. WebDr. management, Macular The Affordable Care ACt also cuts increases in payment to hospitals and nursing homes by 1% a yearevery year. Very sad stories. A hard worker, he managed to knock off those 585 procedures in just two years, from 2007 to 2009. If a colleague tries to bring this to the attention of the administration, He left Mount Sinai in March 2021. As for whether hospitals can make money on Medicare-or lowered Medicare payments sse the Medicare Payment Advisory Commission report which I have referenced in the past showing that Dartmouth helped expose the problem. In, 1 Gustave L Levy Pl # 1030, New York, NY 10029, Your Privacy Hamburger To be included, individuals must have been employed at a tax-exempt organization that filed a Form 990 for 2019. How much is a visit to Dr. Samin Sharma M.D.? and In my own case in 2005, there were some symptoms and a stress test showed a significant adverse change from my prior stress test a year or so earlier. 4 Go-To Resources for Diabetic Heart Disease Management, Looking for a Protein-Rich, Plant-Based Snack? Greater transparency will make it much harder for those who manufacture stents to paint a rosy picture of risks versus benefitsthe FDA aims to make sure that these companies are not hiding information about risks. VA As for hospitals having greater market power as phyisicans abd hospitals consolidate, the government pays more and more hospital bills, the makket is not going to determine prices. Court findings of fraud or willful negligence also expose the doctor to potential punitive financial damages, in addition to the usual compensatory damages. Im not an attorney, so I dont know whether a prosectuor has Dr. Sharma received the Governors Award of Excellence (2006), for his outstanding Wall Street likes them too. Bob Wachter, Professor of Medicine and Chief of the Division of Hospital Medicine at the University of California, San Francisco, comments on the patient response: Most of his patients were probably quite content many had chest pain and a stent undoubtedly seemed like an appropriately aggressive, high-tech cure. And, research shown that while angioplasty with stents offers them quick relief from pain, over the long term, their angins often comes back. Any savings the physicians achieve remain with their group, unless they share the risk with a hospital; in the latter case, part of the savings flow back to the hospital. Sinais King of Stents, ran a cath lab which was central to this campaign, performing procedures that typically brought in as much as $20,000 a piece for the hospital. Since they were approved in the early 1990s, manufacturers have made a fortune peddling the devices which, they say, can prevent a future heart attack while avoiding riskier and more invasive bypass surgery. By contrast, pain from, say, arthritis, is both annoying and can negatively affect quality of life, but its not life threatening. Number of office visits you've had in the last 2 years: How would you like to confirm your survey information. sclerosis, Parkinson's In fact, in most stent patients the stent most likely is responsible for the pain effects for only a fairly short time, at which point the maximal medical therapy they are almost always on as well takes over and carries most if not all of the weight. He also said that in the two years prior to this year, their costs per adjusted admission grew 3.5% with the comparable number for this year at 2.0%. professor, cardiology: $5,087,562: $1,084,866: $4,002,696: $42,637: Shirish Huprikar, M.D. Meanwhile, Medicaid pays them less than 70% of their costs with more payment reductions coming due to state fiscal pressures. In 1983, he came to New York to undergo residency in Internal Medicine at the NY Infirmary-Beekman Downtown Hospital (1983-1986), fellowship in Cardiology in Elmhurst Hospital (1986-1988), and interventional training at The Mount Sinai Hospital (1988-1990). The CFO said their current margin on their Medicare business overall ranges from 0 to -10%. (You will find the abstract here) Following a two-year study, researchers at the Cedars-Sinai Medical Center in Los Angeles are now suggesting that the putative superiority of drug-coated stents is founded on questionable premises. Or as The Wall Street Journal put it, the clinical trials of drug-coated stents (mostly funded by manufacturers), may have exaggerated their real-life advantage. [Dr. Midei was using a new generation of drug-coated stents.]. "Cash compensation" includes base compensation, bonus and incentive compensation, and other reportable compensation from the hospital and related organizations. Sharma convinced his bosses that to capitalize fully on the stent boom, Mount Sinai should turn his cath lab into a 24/7 operation. Its not that easy for them to reduce costs in the short term. The rest of the complicated motives behind this, ranging from the desire of their hospitals to keep expensive equipment paying for itself to personal prestige to the financial rewards to the feeling that if they dont do something they might be sued all enter into the mix, but the first is the main thing. security, Community Well Even if the interventional cardiologist knows that the patient has stable angina or is non-symptomatic, if the percent blockage is above the threshold, and he doesnt put a stent in, what if the patient has a heart attack in the next week / month / year? health, Digestive Physicians and scientists on the faculty of the Icahn School of Medicine at Mount Sinai often interact with pharmaceutical, Monday, the Finance Committee released a 1200-page report. MedPAC has found that the cost of operations at a great many hospitals is much, much higher than it needs to be. More imporantly, when patients undergo angioplasty with stents, long-term repeated reserach shows that their chances of suffering a heart attackor dying from a haert attack are NOT REDUCED.. Barry Stent Scandal: A Shocking Story, But Not News, Center for Medical Consumers reported in 2006. Part of the problem is that in these cases, the doctor may well have thought that he was helping the patients. 5- Several officers are listed on Forms 990 for multiple hospitals within Mount Sinai Health System. Tools & Topics, Find nutrition, Sexual I personally once had a stress ecg clear back when I was in my late 40s as a screening test at the urging of my doctor despite being asymptomatic at the time. If it can be demonstrated that a doctor was willfully negligent or engaged in fraudulent behavior, many, perhaps most, malpractice policies have clauses that obsolve the insurance company of responsibility, potentially leaving the doctor responsible for the entire cost of settlement or judgements themselves. Biologist Upasna Sharma wins $1.18 million grant from health, Breast plan, Public disease, Rheumatoid In some cases, he reports, when health care plans have been asked to cover a new, as yet unproven treatment, they have said: Try it. At $2300 a pop (vs. a mere $700 for the uncoated, bare-metal variety), the newer stents are far more profitable. Because physicians insurance participation can change, the insurance information on this page may not always be up-to-date. As for Medicare paying hospitals less: this will begin quite soon. You are correct-you if you make physical contact with your victim, thats battery. Sharma has built a 250-bed heart hospital (EHCC) in his native Jaipur, India to provide the best care to all patients irrespective of their financial and social status. This live program focuses on helping the audience understand the complexity of interventional disease management. As the number of specialists in a community grows, many people cut out visits to their primary care physicians altogether. He is one of 595 doctors at The Mount Sinai Hospital and one of 114 doctors at NYC Health + Hospitals / Bellevue who specialize in Cardiology. patients guide to managing ankylosing spondylitis, Managing For after reviewing outcomes research, Cedars Sinais clinicians found that the drug-coated stents increase the danger that a blood clot will form inside the stent months, or even years after the procedure. Malpractice insurance generally does not cover punitive damages. Sharecare, Editorial Cases like this one are terribly troubling, he continues, not just because they harm individual patients but because they do violence to the trust that is so fundamental to the physician-patient relationship. Under the directorship of Dr. Sharma, the Live Symposium of Complex Coronary & Vascular Cases (www.cccsymposium.org) started in 1998 and has had overwhelming attendance every year (attended by >800 delegates). Physicians and hospitals also can receive bonuses of as much as 10 percent by doing well on nationally recognized process and outcomes measures. and immunizations, Lung He has authored over 350 articles, 420 abstracts, 15 book chapters and three books to his credit. Dr. Sharma has developed a state of the art Heart Hospital (Eternal Heart Care Center, EHCC) in his native place Jaipur, India, which provides excellent care to all kinds of patients, including underprivileged and those living below the poverty level. Equity (Stock or stock options valued at greater than 5% ownership of a publicly traded company or equity of any value in a privately held company). A regular fixture on international, national, and local TV stations, newspapers and magazines, Dr. Sharma has been the focus of news stories for media outlets like: The Today Show, CBS News, NBC News, Fox News, PIX11, The New York Times, The Wall Street Journal, New York Magazine, Reuters, Businessweek, Cardiology Today, India Abroad, India Today, Barrons, Forbes, Newsweek, The Washington Post, CrainsNew York Business, NY Daily News, Newsday and New York Post. Studies still do suggest that stenting is the preferred treatment in either acute heart attacks or in unstable angina, but the studies are very convincing, as shown elsewhere on this and the related thread, in showing that there is no real advantage and most likely a slight disadvantage to managing both standard angina and non-symptomatic coronary artery disease with stents instead of medical therapy alone. Ideally, the nations paper of record would launch an investigation by looking into the use of stents in its own backyardManhattan. Administrators at the California hospital should have realizled that something unusual was going on. Bruce Leff and Thomas E. Finucane have termed gizmo idolatry.. Conversely, I also wonder how many patients who receive stents would have been better off for the longer term with a CABG. control of type 2 diabetes, Diet For heart patients, medication, and diets like Bill Clintons plant diet are likely to be favored. A doctor who knowingly performs unnecessary surgery or hospializes patients who dont need to be hospitalized is bilking the insurer while harming the patient, and can go to jail. Sharma wanted to let As Dr. Hadler points out in his guest post, there are many ways for physicians to rationalize their use. These CEOs are making 7-figure salaries as a reward for running a hospital as a revenue center (as opposed to a patient-care center).Of course they will say that the government isnt paying hospitals enough. DR Such clots can be life-threatening. For example, the Sun reports, "Dr. Mideis [use of stents] increased, by his own estimate, 50 percent, to about 1,200 a year., As for Mt. and treating thyroid eye disease, A relations, Breast He attended and graduated from Wayne State University School Of Medicine At the time Dr. Thomas Graboys, a professor of medicine at Harvard Medical School, told the Center for Medical Consumers that stents are virtually useless, in stopping the progress of the disease itself. The public is looking for a magic bullet, Graboys warned. Maggie Dr. Sharma in specializes in Cardiology. Yet it wasnt until one of Patels fellow doctors at last secretly sued him in federal court under a special whistleblower law that the hospital revoked his admitting privileges. Find Dr. Sharma's phone number, address, hospital affiliations and more. This is the usual complicated stew of motives for performing tests and procedures that are not scientifically warrented. Soon the lab was averaging 15 off-hours patients a month. WebDr. Its fast, but a band-aid fix. In a study colliding with established practice, recovery from small heart attacks went just as well when doctors gave cardiac drugs time to work as when they favored quick, vessel-clearing procedures, the NEJM reported. Intent is very important. Find contact information here to make an appointment. As a society, we are getting exactly what we tolerate which as of this writing, includes skyrocketing health care costs, and almost exactly 500 innocent deaths . thank you Dr Sharma. Pat At Lourdes, there were rumors for years that one of its surgeons, a Dr. Mehmood Patel, was performing vast amounts of unnecessary heart operations. He got in touch with the blog to point out that he performs 1,500 complex coronary interventions each year, which apparently is an American record, Cardio Brief noted. . device and biotechnology companies to improve patient care, develop new therapies and achieve scientific breakthroughs. 1- Officers' compensation was funded by Mount Sinai Hospital, Icahn School of Medicine, Mount Sinai Beth Israel, Mount Sinai West, and/or New York Eye and Ear Infirmary. | Stent Scandal: A Shocking Story, But Not News Today, stents are used in 85% of all coronary interventions in the United States. While I occasionally have some chest pain from time to time, its minor and the medical regimen continues and will continue indefinitely. Sinais Stent star, Cardio Brief, a blog for cardiologists and other cardiovascular health care professionals, heard from Dr. Sharma just last year, shortly after the Brief reported that Columbia University cardiologist Jeffrey Moses had earned $2.5 million in 2006-7, vaulting him to 8th place in the Chronicle of Higher Educations Hit Parade of individuals receiving the highest total compensation at private colleges, 2006- 2007. Apparently Dr. Sharma was miffed. All, About I have a different take on this. 3- Lorin was named President of Mount Sinai Brooklyn in May 2018. To be included, individuals must have been employed at a tax-exempt organization that filed a Form 990 for 2018. While looking at overtreatment, Dartmouth researchers realized that Redding was doing an extraordinary number of bypasses and angioplasties. He also enjoys teaching other cardiologists through the annual live symposium called the Complex Coronary Cases (CCC) Symposium, which is in its 22nd year. and treating Crohns disease, You 1. As Maggie says, doctors who engage in inappropriate care are guilty of malpractice, a violation of contract (civil) law, not criminal law. 954 salaries reported, updated at April 25, 2023 In February the U.S. Senate Committee on Finance, which oversees Medicare and Medicaid, began investigating. As Pat S. points out, in his comment, anecdotes (or stories you hear from people with an ane to grind) are one thing; MedPACs well-documented analysis is another. Government (taxpayers) already pays more than 50% of all health care bills in the U.S. Yet for years before, their building reputations as top-notch cardiologists brought in patients from all over Northern California.
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