Someone Was Caught With Their Hand in the Cookie Jar.

Men, this stuff that sources sling around about American's wanting out of this war, not wanting to fight, is a crock of bullshit.  Americans love to fight traditionally.  All real Americans love the sting and clash of battle.  You are here today for three reasons.  First, because you are here to defend your homes and your loved ones.  Second, you are here for your own self respect, because you would not want to be anywhere else.  Third, you are here because you are all real men and real men like to fight.  When you, here, everyone of you, were kids, you all admired the champion marble player, the fastest runner, the toughest boxer, the big league ball players, and the All-American football players. America loves a winner. Americans play to win all the time. I wouldn't give a hoot in hell for a man who lost and laughed.  That's why Americans have never lost nor will ever lose a war; for the very idea of losing is hateful to an American............................We have the the finest hospitals, the finest medical technology, and a fine generation of surgeons that money can buy.  Why by God, I pity those poor sons of bitches we're going up against.  By God I do.

                                                         - General George Patton/TSB -

On Monday, December 6, 2010, the NY Times, that bastion of liberal news, ran an article about a Baltimore cardiologist, Dr. Mark Midei, who had inserted 30 cardiac stents in a single day in August 2008. With the WikiLeaks controversy being played out in the media, many corporate executives are learning that maybe its time to tone down their e-mails, witnessed by the comment by an Abbott executive who wrote, "this is the biggest day that I ever heard about."  Of course the salesperson did not help matters when two days later the Abbott sales rep showed up at Dr. Midei's home with  a whole slo-smoked pig, peach cobbler, along with all the fixin's.  Hopefully they bought their barbeque sauce from you know whom. Total cost: $2,159.  The dinner was just a small token of appreciation in comparison of the millions that were already showered on Dr. Midei for putting more stents than any other cardiologist in Baltimore.  The irony is that Dr. Midei is accused of putting stents in patients that did not need them.

The 10,000 documents from Dr. Midei and St. Joseph's located in Towson, Maryland (what's in the water at St. Joe's) concludes that he implanted 585 stents which were medically unnecessary from 2007 to 2009.  This case has turned into a legal quagmire for Dr. Midei and St. Joe's.  They are now being sued by hundreds of patients who claim they have received unnecessary implants.  Some doctors have been quoted as saying, that this case has revealed a level of care that is more common than most patients know.

Dr. Steven Nissan, chief of cardiovascular surgery at the Cleveland Clinic states "that what is going on in Baltimore, is going on right now in every city in America.  We're spending a fortune on procedures that people don't need."  Of course Dr. Midei's attorney said that his client will be exonerated (what else would anyone expect from a lawyer), yet last month good ol' St. Joe's agreed to pay $22 million dollars to settle the charge that it paid illegal kickbacks to the good ol' doctor in exchange for patient referrals.  As usual, the hospital denied any wrongdoing.  Considering how much Medicare spent on stent procedures, $3.5 billion, its a wonder the feds aren't investigating other specialties, ahmmmmmm spine.

Enter the federal government.  Senator Max (I'm every insurance companies best friend) Baucus who was quoted as saying that "this could be a sign of a larger national trend of wasteful medical device use." Hey Maxie, where have you been, are you kidding me?  How many war stories have we heard where some surgeon is implanting 'X" amount of interbody devices every week, let alone every month.   All one has to do is look at all the fly by night interbody companies that have surfaced and continue to do so. Ever wonder why?  Like trickle down economics, eventually, cases like these open up pandora's box, exposing all the dirty little secrets and evils between the medical device world and physicians.  Yet, hope springs eternal that the majority of surgeons in spine do the right thing, especially for their patients.  TSB wants to know, is it the beginning of the end, or is it business as usual?