A Bloomberg Businessweek article published September 26 addresses important questions about the overuse of stents, a life-saving medical technology. They are not new questions, however.
These questions have been studied in great depth, debated vigorously and acted upon by interventional cardiologists and others in recent years as new scientific evidence emerged about appropriate use of stents to treat blocked arteries. These efforts, led by the Society for Cardiovascular Angiography and Interventions (SCAI) and other medical specialty societies, have resulted in practice guidelines, appropriate use criteria and quality assessment for the more than 4,000 interventional cardiovascular practitioners in the United States.
Patients should therefore be reassured that the decision to implant a stent is influenced by a scientifically rigorous set of practice standards and guidelines that serve as checks and balances to keep physicians accountable.
No one, and certainly not our Society, in any way defends physicians or condones practice that puts patients at risk through fraud or overuse of medical technology for personal gain. They should face the consequences of their actions, and many have, as the article reports.
Most physicians work hard to make the right decisions with their patients and believe patient well-being comes first and must be at the center of treatment decisions. With more than 700,000 stenting procedures performed each year, it is crucial to maintain a sense of perspective about stenting, which saves lives and restores patients with distressing and limiting symptoms to active lives.
Good care extends beyond raw statistics into the realm of clinical judgment: What is each patient’s history and realistic expectations, involving their medical treatment and expected clinical outcomes, including lifestyle? What are their symptoms, experience with medical therapy, living situation and other personal factors? We must never lose sight of the central role of a physician’s clinical judgment in assessing a patient’s needs.
We at SCAI are proud of the many dedicated professionals in our field who work hard to save lives and do the right thing for their patients.