The Society for Cardiovascular Angiography and Interventions (SCAI) is deeply disturbed by findings in a report issued today by the U.S. Senate Finance Committee concerning allegations of inappropriate use of stent technology by a doctor in Maryland. SCAI's mission is to provide education, advocacy, and standards supporting the delivery of optimal quality cardiovascular care, as defined by evidenced-based practice guidelines and appropriate use criteria developed by the world's leading cardiologists.
SCAI's Code of Ethicscalls on the Society's 4,000 members to comply with a strict, clear set of ethical principles, including:
- Clinical decision making must be based on the patient's welfare and best interest.
- Competent, appropriate, evidence-based medical care must be provided with compassion and respect for human dignity.
- All interactions with patients must be provided without inappropriate external influence.
- Performing inappropriate procedures on patients is profoundly unethical and grounds for permanent loss of membership in SCAI.
- Members will accept and cooperate fully with independent, periodic peer review as a critical component of patient safety and continuous quality improvement in their practice.
SCAI's leaders are experienced interventional cardiologists, many of whom were trained by the founders of the field and now are training the next generation of practitioners. Based on these leaders' perspective from daily practice and years of interaction across the country - including rigorous experience with peer review -- SCAI firmly believes inappropriate use of stenting and other therapies is rare. The vast majority of Board-certified interventional cardiologists adhere to the principles in SCAI's code of ethics.
SCAI cannot comment on the merits of ongoing investigations. However, the Society finds intolerable the use of inappropriate or unnecessary procedures and has made that position clear in its code of ethics. SCAI has been engaged for decades in the development and promotion of quality assurance efforts, including independent peer review of cardiovascular cath labs and participation in national database registries to support evidence-based standards of care.
A task force comprised of SCAI members and the Maryland Chapter of the American College of Cardiology (ACC) has been working with Maryland lawmakers and regulators over the past year. The task force has offered draft legislation, the Maryland Cardiovascular Patient Safety Act, which would make cath lab accreditation, along with other quality assurance measures, mandatory. These and other quality assurance measures are essential to ensuring that patients receive the care they need.
As the Senate Finance Committee report states, "Cardiac stents are among the medical miracles that can greatly improve someone's life." There is no question that angioplasty and stenting is the undisputed gold standard for treating heart attacks. In fact, few medical advances have so dramatically lowered the rates of death and disability from cardiovascular disease, which remains the leading killer of both men and women in the United States. Evidence-based, appropriate use of interventional therapies saves lives and improves quality of life for patients who suffer from heart disease. Coverage of controversial practices by one or even a handful of physicians must not be allowed to obscure that fact for people with potentially fatal or devastating symptoms.