The teachable moment

Tweets are flowing about George W. Bush's annual stress test and the resulting angioplasty and stent insertion.  Why? Because the care provided to our last President is inconsistent with current evidence-based medicine recommendations. Indeed, hospitals would risk non-payment from the government and private insurers for the type of treatment received by Mr. Bush.

Here's a full description from Burt Cohen's Stent Blog.  He links to a number of tweets from people, including Eric Topol, who says:

Relative to Pres Bush, here are the @ACCinTouch recommendations against stress testing http://www.cardiosource.org/News-Media/Publications/Cardiology-Magazine/choosing-wisely.aspx

Burt Cohen notes:

Was a CT angiogram necessary?

This test is not currently covered by Medicare or most insurance providers for this indication, mainly because it’s considered one of those “over-used unnecessary tests.”


He follows:

Was a stent necessary?

Or could Bush’s coronary artery disease have been managed with optimal medical therapy. 


Noting the absence of public comments about this from many prominent health care experts and commentators (Dr. Oz, Sanjay Gupta, Atul Gawande, Don Berwick, ex-Surgeons General, AARP, Brian Williams, the American College of Cardiologists), a friend summarizes:

You and me, and everyone who gives a hoot about the health care system talks of the adult conversation and the teachable moment.  Look in the mirror.  I would call what we have in front of us a whopper.  

If W did indeed have a screening stress test, mind you--in an incredibly fit, teetotaling, non-smoking Texan, then who will be a immune from over testing and misuse of resources?

We have a root cause of system ills right in front of us, but the A in RCA, i.e, the analysis caboose, has seemed to decoupled from the engine.
 
Indeed, where are the mainstream media and the advocates?  Are you afraid to challenge this type of care because it involves a member of the country's ruling class?  In doing so, do you implicitly advocate a two-tiered system of care for the country? One where the rest of us pay for "royalty" to receive a more costly level of care than the rest of us?

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