Just when you thought it was safe to read the paper again, along comes a New York Times report suggesting that not all cardiologists have learned the seemingly obvious lessons from the overuse scandals from the past decade.
In a front page article in Sunday’s business section, Julie Creswell writes about the ongoing controversy and scandal involving cardiologist Arvind Gandhi, who is accused of enriching himself by performing hundreds of medically unnecessary procedures on his patients in the small town of Munster, Indiana. 293 patients are now suing Gandhi and two other doctors in his practice. The Indiana state Medicaid program and the US attorney’s office are also investigating the case.
Gandhi was “a star” at his local hospital for 30 years. “He and his partners not only ran the most popular cardiology practice in Munster but were also the highest-paid heart doctors in the state in terms of Medicare reimbursements, records show,” writes Creswell. “Gandhi and his partners, Dr. Wail Asfour and Dr. Satyaprakash Makam, received nearly $5 million in combined Medicare payments in 2012, making them the three most reimbursed cardiologists in Indiana.” One of the partners, Makam, drove “a blue Porsche with the license plate ‘Tick Doc’.”
The article quotes Mark Dixon, who had been the medical director of the hospital’s electrophysiology lab. When Dixon “raised concerns to a hospital executive in 2005 about whether Dr. Gandhi and other physicians were qualified to implant the devices, he said he was shut down. (According to the article Gandhi was not an electrophysiologist.)
“The response to me was, ‘I understand your concern, but we have a very large producer here who wants the privilege,’ ” Dr. Dixon said last year in a deposition in a lawsuit. He said he was later told to stop reviewing implants performed at the hospital by the nurse manager of the lab.
Lawyers defending Gandhi said that the high billing was a reflection of an older and sicker population in Munster. But “when investigators at the Dartmouth Institute studied rates per capita for procedures that must be treated — a hip fracture, for instance — Munster was below average in the state.”
Another electrophysiologist, Dr. Scott Kaufman, has been working with the malpractice lawyers after treating one of Gandhi’s patients who had a pacemaker-defibrillator device that was clearly unnecessary and that was harming her. He told the Times that 11 of 15 former Gandhi patients who he has seen had had unnecessary procedures performed on them.