Del. Pete Hammen asked state agencies to investigate "the possibly unneeded procedures/stent placements" but "cautioned them against jumping to conclusions" ("Md. broadens stent investigation, June 6).The jumping had already been done over a year ago. The result: an excellent doctor, Mark Midei, has been out of work for a year now and cannot support his family of six.
After state agencies did their investigating, they determined that doctors, after doing "heart cath's" typically find blockage, requiring treatment with a stent about 30 percent of the time. Delegate Hammen and others say data suggests Dr. Midei performed procedures nearly twice as often.
The same article says St. Joseph's is a cardiac referral center and frequently receives complicated cases from referring physicians and other hospitals, so the hospital's volume as well as Dr. Midei's would be higher. (It doesn't take a rocket scientist to figure that part out).
Arthur Caplan, Chairman of the Dept. of Ethics, University of Pennsylvania said," differences in the rate of procedures can be caused by a variety of benign reasons, even variations of medical training." He also said "for most of the things that are overused, there is an amazing relationship to profit." What else can we expect, medical care is a business, however there needs to be careful consideration here.
Over and over I have heard in the media or read in the Sunpaper that St. Joseph's was reviewing records from just the past two years. I personally received a letter from St. Jos. stating my stent may have been unnecessary. I don't have a stent, having never been a patient of Dr. Midei. I was an overnight guest at St. Jos. via the emergency room. I was experiencing chest pain, and the person who took me said where do you want to go, I live right around the corner from another hospital, but I said St. Jos. they're the best. This was June, 1998, the only time I was ever a patient there, and that's certainly more than 2 years ago. I did however meet Dr. Midei, three or four years ago, when my husband needed a heart catheterization. Dr. Midei explained the test results and recommended nothing at that time. My husband did not receive a stent or a letter.
Hospital officials, after concluding their investigation, said they were tipped off by a patient complaint in 2009. I hear the patient is also an employee. Why has this persons name not been smeared all over the place? Perhaps they are a friend or relative of the CEO of Mid Atlantic Cardiovascular Associates, where Dr. Midei was employed, and left to become a full time employee of St. Jos., thereby destroying a $25 million merger deal with Medstar Health. The CEO told Dr. Midei "I will spend the rest of my life trying to destroy you personally and professionally." What was that CEO's name again? Where is that person today? Evidently, this was not an idle threat!
Why is St. Josephs' making undisclosed agreements with the federal government to settle any potential claims? And why does this specifically involve the Department of Justice?
Should all St. Joseph's employees be watching their back, lest someone else throw stones at them?
Last but not least: In June 2010, State regulators reviewing billing records determined other doctors in Maryland have suspiciously higher rates of placing stents. What a surprise! How can this be? Is it all business as usual? Is the placement of stents preventive measures to keep patients from a rapid decline? Could it be more and more people are now needing this procedure? Or, has Dr. Mark Midei been right all along and this mess has all been the result of a threat fulfilled?
JoAnn Wingate, Overlea