Lost Legs Doctors and Healthcare Giants Profited.
Lost Legs Doctors and Healthcare Giants Profited.
Kelly Hanna’s leg was amputated on a summer day in 2020, after a doctor in Michigan who dubbed himself the “leg saver” had damaged her arteries by threading metal wires through them to clean away plaque. The leg saver had attempted to eliminate the plaque by snaking the wires through her arteries.
It began with an open wound on her left foot that began to fester. Mrs. Hanna was recommended to see Dr. Jihad Mustapha by her podiatrist. He performed at least that many artery-opening procedures on Ms. Hanna’s legs over the course of 18 months, telling her that they would increase blood flow and prevent amputations. The treatments took place in both of her legs.
They did not, not for Ms. Hanna nor for the majority of his other patients. Because so many of his patients required amputations and had other health issues, surgeons at adjacent hospitals felt compelled to file a formal complaint with the Michigan Medical Board against his behaviour. In the past four years, treatment at his clinics reportedly resulted in the amputation of limbs for 45 patients, as reported by an insurance company to state authorities.
According to the findings of an inquiry conducted by The New York Times,
Dr. Mustapha is not a back-alley operator working in the shadows of the established medical community. He has become a leader of a flourishing cottage business that peddles risky operations to millions of Americans, rewarding doctors and gadget firms while sometimes costing patients their limbs. The financial backing of medical equipment manufacturers has allowed him to achieve this status.
The industry targets the approximately 12 million Americans who suffer from peripheral arterial disease, which is characterised by the accumulation of plaque in the arteries of the legs. Plaque is a sticky slurry made up of fat, calcium, and other elements. Plaque can restrict blood flow in a very small percentage of patients, which can result in the need for amputations or even death.
But research conducted in the medical field over the course of more than a decade has shown that the great majority of people who have peripheral artery disease have very moderate or no symptoms and don’t need therapy other than increasing the amount of physical activity they get and taking medication. Even people who do have severe symptoms, like Ms. Hanna, should not go through many procedures in a short period of time, according to the recommendations of experts.
A significant number of persons who have peripheral artery disease also have heart disease or diabetes, two conditions that carry significant dangers. These patients, who are already worried about their health, are more likely to believe their doctors when they tell them that they risk losing their legs if they do not undergo invasive medical operations.
Plaque can be pushed to the side of arteries with the help of certain medical devices,
such as metal stents or nylon balloons. Others remove plaque from the arteries using a procedure called an atherectomy, which involves inserting a wire equipped with a laser or a very small blade into the artery. Atherectomy is a particularly dangerous surgery, according to the findings of extensive medical research. Patients with peripheral artery disease who have atherectomy are more likely to require amputations than patients with the disease who do not have the procedure.
The number of patients undergoing these vascular treatments has been steadily increasing. In particular, the utilisation of atherectomy procedures has skyrocketed, according to an examination of Medicare payment data conducted by the Times. By one metric, the number of atherectomy procedures performed has more than doubled in the previous ten years.
There are two primary causes for this. To begin, the government has altered the manner in which it pays physicians for certain treatments. In an effort to bring down the overall cost of medical care, Medicare began offering financial incentives to physicians in the year 2008 for carrying out a wide variety of procedures outside of hospitals.
A few years later, it began compensating doctors for outpatient atherectomy procedures,
turning the operation into a guaranteed source of revenue. When doctors saw the potential, they moved quickly to capitalise on it by creating their own outpatient clinics. By the year 2021, they were billing $10,000 or more for each atherectomy they performed.
The second reason is that businesses that manufacture equipment for vascular operations have invested money into a relatively new area of medicine in order to establish a market for their products.
When individual physicians decide to create their own vascular clinics,
large firms like Abbott Laboratories and Boston Scientific are there to offer assistance in the form of training as well as billing pointers. The multinational electronics corporation Philips collaborates with a financial services firm to present clinics with the opportunity to acquire loans for medical technology and to receive price reductions for doing a greater number of treatments.
The Times conducted a search through a database of state loan filings to identify the top 200 physicians who have submitted the most claims to Medicare for atherectomy procedures since 2017. At least three quarters of them are either recipients of loans from the medical device sector or work at clinics that have received such loans. Some of the loans have been given to physicians who have a well-established track record of putting their patients in danger.
