.The Texas Medical Board last month accused a widely known cardiologist in Austin of inserting unnecessary stents. NG stent procedures offer relief from the pain of angina for a whilebut not forever. He worked as a Hospitalist at Medical Centers in Michigan Massachusetts, and New Under reform, accountability is likely to extend beyond the individual patient-doctor relationship. When they have positive findings, the logical next step is to send the patient to cath. Residency, Internal Medicine, New York University Downtown Hosp. Major emphasis of the live course has been the technical aspects of safely performing complex coronary interventions. No segment of professionals escape more appropriate discipline upon being found guilty. . There is some irony in the fact that the same researchers who enthusiastically extend hope to individual patients are, almost without exception, far too practical about the actual value of their experimental care to risk their own income., ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~, Monday, the Times story acknowledged that Prosecutors, malpractice lawyers and state medical boards are only now waking up to the issue . If you are using Internet Explorer, please consider upgrading to a modern browser. Why has it taken so long for state medical boards to wake up? He has authored over 350 articles, 420 abstracts, 15 book chapters and three books to his credit. Dr. Sharma has developed a state of the art Heart Hospital (Eternal Heart Care Center, EHCC) in his native place Jaipur, India, which provides excellent care to all kinds of patients, including underprivileged and those living below the poverty level. He received his medical degree from Sawai Man Singh Medical College and guide to managing wet age-related macular Steamed Veggies or Raw Veggies for Healthy Cholesterol? Cases like this one are terribly troubling, he continues, not just because they harm individual patients but because they do violence to the trust that is so fundamental to the physician-patient relationship. . A product of Crains New York Business. He attended and graduated from Wayne State University School Of Medicine Dr. Sharma caregiver, Sharecare Any savings the physicians achieve remain with their group, unless they share the risk with a hospital; in the latter case, part of the savings flow back to the hospital. (Im pretty sure I know the hospitals you are referring to) What did you think these CEOs would say? Back in June of 2006, a few months before I began HealthBeat, I wrote a post about our use of stents for The Health Care Blog. ), The problem is this, he concludes, as long as the cardiologist reading the cath is the one who pulls the trigger on the intervention, we have a potential Fox/Henhouse problem., What may be most troubling about the Medei imbroglio is that it highlights how our infatuation with high-tech medicine tempts us to ignore medical evidence. Such clots can be life-threatening. 4- Bruno left in October 2018. Our Lady of Lourdes Regional Medical Center in Lafayette, Louisiana, provides another example of how high-volume rogue surgeons can escape scrutiny for years, either because hospital administrators dont know, or profit from pretending not to know, how dangerous they are. He currently practices at Mount Sinai Cardiology Assocs in New York, NY. This is because they are terribly inefficient. I felt relief., Although this patient, 66-year-old Peggy Lambdin, later received a letter indicating that her coronary artery was less than 50 percent blocked (clinically meaningless and not an indication for stenting), she was unfazed, Wachter observes. What any cursory investigation reveals is truly jaw-dropping: 1. To search within a table, use the box in the upper right corner. Samin Sharma, M.D. Dr. Sharma provides telehealth services. He may well believe he is saving lives. Dr. Samin Sharma, MD is a Cardiology Specialist in New York, NY. He currently practices at The Lauder Its one thing to close your eyes when a colleague is wheeling one patient after another into the cath lab, quite another to associate your name with his activity. policy, Press In some cases, he reports, when health care plans have been asked to cover a new, as yet unproven treatment, they have said: Try it. Samin Sharma, MD, is a specialist in internal medicine who treats patients in San Antonio, TX. Because physicians insurance participation can change, the insurance information on this page may not always be up-to-date. Samin Sharma, M.D. What Cant Happen, Wont. Mount Sinai Heart reaches $5 million endowment goal for the Dr. Samin K. Sharma Family Foundation Cardiac Catheterization Laboratory. This provider has not specified a telehealth appointment method. The Massachusetts Blues program is the first major global capitation effort on the East Coast in a decade. In my experience, these folks become as adept at reading cath films as any physician. WebDr. health, Hepatitis 2- Mo was president of Mount Sinai Brooklyn until mid 2018 and then transitioned to a role as executive vice president. In many cases, the malpractice insurance that was in force for the incidents had been acquired two decades earlier and had cash limits that were way too low for the settlements and judgements that were being given, leaving the pediatricians, many of whom had already retired, to pay 7 figure awards out of their own pockets. training you makes doctors extremely sensitive to criticism. plan, Public whilst Im enthusiastic about CMS moving toward capitation, Im not holding my breath. Barry As Pat S. points out, in his comment, anecdotes (or stories you hear from people with an ane to grind) are one thing; MedPACs well-documented analysis is another. Since they were approved in the early 1990s, manufacturers have made a fortune peddling the devices which, they say, can prevent a future heart attack while avoiding riskier and more invasive bypass surgery. If hospital compliance departments want to perform their own audits as well, more power to them. Web8 DR. SAMIN K. SHARMA FAMILY FOUNDATION | CARDIAC CATHETERIZATION LABORATORY . Going forward, govts share will grow (as more people age into Medicare, and as as Medicaid and SCHIP expand). If you are using Internet Explorer, please consider upgrading to a modern browser. professor, cardiology: $5,087,562: $1,084,866: $4,002,696: $42,637: Shirish Huprikar, M.D. He is also great teacher . guide to managing depression, Understanding The main issue, in truth, is probably that the doctors believes that they are doing the right thing, based on their grasp of the science and their personal feelings about what they are doing, possibly influenced by personally not having kept up on the science and by the continued insistence of academic doctors with career stakes and of reps from supply, equipment, and drug companies that the evidence against the procedures are flawed, incomplete, or dont apply to a brilliant person like themselves who gets far better results than the people at institutions where the research is done . Sharma served on the Cardiac Advisory Board of New York State from 2004-2016, which advises the Health Department and the Governor on issues of health policies and supervision, safety, and appropriateness of heart care by various hospitals in New York. sciences, Sharecare+: Upasna Sharma (photo by C. Lagattuta) Upasna Sharma, assistant professor of molecular, cell, and developmental biology at UC Santa Cruz, has received a $1.18 His point is that the physician who diagnoses the need for stents shouldnt be the one who also performs the procedure. Sharma convinced his bosses that to capitalize fully on the stent boom, Mount Sinai should turn his cath lab into a 24/7 operation. Established patients should expect a typical charge of $121.62 and an average copayment of 30.4. These hospitals need only two ORs. us, Close WebDr. The Baltimore Sun notes that after a landmark 2007 study in the New England Journal of Medicine concluded that stents were often not beneficial, enthusiasm waned. Sign up here to receive e-mails alerting you when she has published new posts. Even in Redding, California, where a doctor performed hundreds of unnecessary bypasses and angioplasties, he did not go to prison. But hospitals cant bill $12,000 for deciding not to implant a stent, even if thats the best thing for the patient.. In February the U.S. Senate Committee on Finance, which oversees Medicare and Medicaid, began investigating. As for hospitals having greater market power as phyisicans abd hospitals consolidate, the government pays more and more hospital bills, the makket is not going to determine prices. He is one of 595 doctors at The Mount Sinai Hospital and one of 114 doctors at NYC Health + Hospitals / Bellevue who specialize in Cardiology. Back in 2003, THCB quoted a Stanford study which suggested that, over the long term, patients with multi-vessel disease would achieve better outcomes, at a lower cost, if they opted for the bypass operation. Titles reflect positions held in 2018. device and biotechnology companies to improve patient care, develop new therapies and achieve scientific breakthroughs. The stent story illustrates a major problem in our money-driven health care system. The Baltimore Sun broke Dr. Mideis story in January. If a colleague tries to bring this to the attention of the administration, The PA hospital system is based in Philadelphia, not Pittsburgh. If Medicare payments rise only 1% or so while their costs continue to go up at 2%, its a formula for continued cost shifting to commercial insurers. At Lourdes, there were rumors for years that one of its surgeons, a Dr. Mehmood Patel, was performing vast amounts of unnecessary heart operations. Peer review is improving Wachter says, but cases like Dr. Mideis dont trip any alarms. Today, stents are used in 85% of all coronary interventions in the United States. Ordinarily, though doctors are not imprisoned for malprctice because society acknowledges that we all are human and even the very best doctors make mistakes. Under the directorship of Dr. Sharma, the Live Symposium of Complex Coronary & Vascular Cases (www.cccsymposium.org) started in 1998 and has had overwhelming attendance every year (attended by >800 delegates). As an aside, I recently met with the CEO, who is also a physician (OBGYN), of a large hospital system in the NYC metropolitan area and the CFO of a well known hospital system in Pennsylvania. Though of course there are extreme cases where a doctor is consciously over-treating, but I suspect those are very rare. It is very very hard for doctors to admit to themselves that something they have been doing for a while is now demonstrated to be of little value or even potentially harmful. 6- Mo was president of Mount Sinai Brooklyn until mid-2018 and served as a system executive vice president until January 2019, when he left Mount Sinai. Sinai hospital: The 2,000-doctor hospital was struggling in March, 2003, when Dr. Kenneth L. Davis took over as chief executive. health, View To be included, individuals must have been employed at a tax-exempt organization that filed a Form 990 for 2018. Office environment, cleanliness, comfort, etc. Chest discomfort, especially if it occurs at rest and not during or shortly after eating is not only stressful, it can be perceived as life threatening. They are not repeated here. You can find other locations and directions on Sharecare. As MedPAC reserach show, when hospitals are under some financial pressure, they find a way to cut waste in what it costs them to deliver care. Bob Wachter, Professor of Medicine and Chief of the Division of Hospital Medicine at the University of California, San Francisco, comments on the patient response: Most of his patients were probably quite content many had chest pain and a stent undoubtedly seemed like an appropriately aggressive, high-tech cure. Dr. Sharma completed a residency at Nyi Bd Hospital. Oh, and by the way, it pays well too. If you're a patient of Samin Sharma,M.D., and a MyChart user, you can: Web Privacy | Links from websites affiliated with UT Health's website (uthscsa.edu) to other websites do not constitute or imply university endorsement of those sites, their content, or products and services associated with those sites. 3. These days Dr. Sharma is one of the U.S.' leading cardiac surgeons, earning more than $1 million a year. Learn more about Dr. Sharma's background, education and insurance providers. That lesson influenced a lot of doctors from my generation, who saw all this happen early in our careers, but lessons that dont quite fit with personal ego and ambition have a tendency to be forgotten after a while, especially by younger people who did not see the events first hand. Dr. Sharma received his medical degree from S.M.S. Clinical Manby Clifton Meador (Why Do So Many Of Us Need Medical Tests to Tell Us That We Are Well? health, Transgender This provider has 21 years of experience and is affiliated with Catholic , The Times went on to quote Dr. Steven Nissen, chief of cardiovascular medicine at the Cleveland Clinic: What was going on in Baltimore is going on right now in every city in America. Nissen added that he routinely treats patients who have been given multiple unneeded stents. Dr. Certainly, hospital executive knew that they were making handsome profits on Mideis stent procedures. can help the patient for a much longer period of time. In fact, in most stent patients the stent most likely is responsible for the pain effects for only a fairly short time, at which point the maximal medical therapy they are almost always on as well takes over and carries most if not all of the weight. I have been researching, investigating, speaking & writing on the ugly reality of physician misbehavior for more than a decade. Dr. Sharma in specializes in Cardiology. 1. Dr. Samin Sharma, MD is affiliated with Mount Sinai Hospital, Mount Sinai West, Mount Sinai Morningside and Mount Sinai Beth Israel. Samin Sharma, Mt. He completed his Residency in Internal Medicine at New York Downtown Hospital in New York, NY in 2009. Dr. Samin Kumar Sharma has 11 locations Mount Sinai Hospital Cardiology 1190 5th Ave Fl 1 New York, NY 10029 (212) 427-1540 ACCEPTING NEW PATIENTS The Mount Sinai Hospital 1468 Madison Ave New York, NY 10029 (212) 241-5881 Mount Sinai Cardiac Catheterization Laboratory 1450 Madison St KCC Bldg New York, NY 10029 Soon the lab was averaging 15 off-hours patients a month. No doubt many of the New Jersey insurers customersand some physiciansobject to the requirement. According to federal investigators, Dr. Midei implanted potentially dangerous cardiac stents in the arteries of as many as 585 patients who didnt need them. I think its encouraging that doctors may be starting to perceive greater litigation risk from doing this procedure as opposed to not doing it. Please note that this information may differ from information posted on corporate sites due to timing or classification differences. But its not just that manufacturers over-estimated the benefits; they underestimated the new risk that the coated stent introduces. cancer, Crohn's Physicians who provide services at hospitals and facilities in the Mount Sinai Health System might not participate in the same health plans as those Mount Sinai hospitals and facilities (even if the physicians are employed or contracted by those hospitals or facilities). * Please verify this information when scheduling an appointment. Ideally, the nations paper of record would launch an investigation by looking into the use of stents in its own backyardManhattan. If a second doctor must sign off on the reading, this could stop a serial stenter in his tracks. You can find other locations and directions on Sharecare, Likelihood of recommending Dr. Sharma to family and friends. In practice, this is rarely invoked except in cases involving falsifying records after the fact, perjury, and other similar things, but in theory it could be in some cases. Tools, Health degeneration, A and The main area where all hospitals have the potential to get better is in reducing 30 day readmission rates and they are all working on that. I was put on maximum medical therapy after the surgery and have been on it ever since. WebDr. Studies still do suggest that stenting is the preferred treatment in either acute heart attacks or in unstable angina, but the studies are very convincing, as shown elsewhere on this and the related thread, in showing that there is no real advantage and most likely a slight disadvantage to managing both standard angina and non-symptomatic coronary artery disease with stents instead of medical therapy alone. In the end, both would lose their licenses, and each would pay a $1.4 million fine in lieu of federal criminal prosecution. Please contact the office to determine whether you are eligible. I have no idea of what the percentages of people who are non-symptomatic who end up getting stents, but simple angina is the most common cause of heart cath and stenting in many centers. doctor, Find Go to a non-hospital-based doctor in the community. In my own case in 2005, there were some symptoms and a stress test showed a significant adverse change from my prior stress test a year or so earlier. each other: anyone who has gone through this deserves to be a doctor. The popularity of stents is all part of a mindset that Drs. arthritis, Type In the meantime, simply releasing payment information would help the press and public target such excess, as the WSJ piece on prostate care indicates. I personally once had a stress ecg clear back when I was in my late 40s as a screening test at the urging of my doctor despite being asymptomatic at the time. He left the system in 2019. Titles reflect positions held in 2019. And I do blame the hospitals. Try Hummus. WebMount Sinai's Dr. Samin Sharma discusses the treatments available for heart disease. The Long-Term Challenge: Next Steps for Healthcare Reform, Lou Dobbs Debate With Douglas Holtz-Eakin, Health Policy and Reform: New England Journal of Medicine, Why Medicare Should Cut Payments to Nursing Homes, Breast Cancer Living with the Disease, Part 2, A Culture of Fear and Intimidation: Reforming Medical Education. At the time Dr. Thomas Graboys, a professor of medicine at Harvard Medical School, told the Center for Medical Consumers that stents are virtually useless, in stopping the progress of the disease itself. The public is looking for a magic bullet, Graboys warned. Pat If the allegations are true, the penalties should be severe, not only for Dr. Midei but also for leaders who knew or should have known what was going on, yet remained silent.. Dr. Sharma has been the recipient of numerous awards for excellence from medical societies and the community, to name a few recent ones: 2014 Physician Scientist Award by AAPI-QLI, 2011 Ellis Island Medal of Honor, 2011 American Heart Association Achievement in Cardiovascular Science & Medicine Award, 2011 American Association of Physicians of Indian Origin (AAPI), 2010 Association of Indians in America (AIA) for Excellence in Medicine, 2010 Honored by AAPI forum of Tri-State Area for Academic Excellence, 2005-2008 and 2011-2021 Best Doctors, 2008-2021 Super Doctors, 2007 Jacobi Medallion Award at The Mount Sinai Hospital, 2007 Physician of the Year at The Mount Sinai Hospital. . In a study colliding with established practice, recovery from small heart attacks went just as well when doctors gave cardiac drugs time to work as when they favored quick, vessel-clearing procedures, the NEJM reported. Sharma currently performs the most interventional cases of anyone in the United States — more than 1,500 per year. Ive read that the hazing experience of med school causes doctors to bond with How much is a visit to Dr. Samin Sharma M.D.? Dr. Samin Sharma, MD is a cardiology specialist in New York, NY. The hospital subsequently agreed to pay a fine of $3.8 million but still denies it had any way of knowing about the safety or effectiveness of Dr. Patels care. Citys hospital specialists are raking in millions of dollars To arrange an appointment, call the number on Dr. Sharma's profile. Do you have any data on the percentage of stent placements that go into patients who are either asymptomatic or have stable angina? Dr. Sharma travels to India every month to teach the art of angioplasty to Indian cardiologists. The research shows that Click on Contact Maggie on the blogs home page. Administrators at the California hospital should have realizled that something unusual was going on. Sharecare, Editorial Each webcast receives >5000 page views globally. In addition to coronary interventions, Dr. Sharma specializes in the non-surgical treatment of mitral and aortic stenosis and transcatheter aortic valve replacement (TAVR). Part of the problem is that in these cases, the doctor may well have thought that he was helping the patients. VA Zones Project, Find It is a good example of the problem of accidentally creating disease by the doctor boxing themselves in with testing that was not needed in the first place. At a cost of $400,000 a year, he figured, the hospital could put enough doctors and nurses on call to do emergency angioplasties late at night and on weekends. patients guide to managing ankylosing spondylitis, Managing 8300 Floyd Curl Dr Fl 4, San Antonio, TX 78229 (210) 450-9800. I take a beta blocker, an ACE inhibitor, a statin, an anti-spasmodic drug and a blood thinner plus baby aspirin. You are correct-you if you make physical contact with your victim, thats battery. He has more than 100 publications and over 500 citings. Dr. Sharma received his medical degree from S.M.S. Medical College in 1978, Jaipur, India, where he was ranked the number one student in his medical school and State University receiving eight gold medals and five honors. Dr. Samin Sharma is a cardiologist in New York, New York and is affiliated with multiple hospitals in the area, including Mount Sinai Hospital and Mount Sinai Beth Israel Hospital. He received his medical degree from Sawai Man Singh Medical College and has been in practice for more than 20 years. Instead, when payers, including commercial payers as well as Medicare and Medicaid notice that a particular doctor and/or hospital is performing an unusually large number of procedures of any type, timely unannounced post-procedure audits should be performed by experts hired and paid for by the payers. Well-Being, Well-Being The Natl Practitioner Data Bank holds files on a whopping 1/4 million physicians just since 1985. Conversely, I also wonder how many patients who receive stents would have been better off for the longer term with a CABG. Drugs and a change of diet Number of office visits you've had in the last 2 years: How would you like to confirm your survey information. During the previous six months, Sinai had lost $50 million, partly as the result of tougher caps on Medicare reimbursement rates. But doctors can go to jail for malpracticetypically if they are found guilty of fraud and malpractice. Indeed, in August of 2008, Abbott celebrated the fact that the handy doctor had inserted 30 of the companys cardiac stents into trusting patients in a single day: Two days later, an Abbott sales representative spent $2,159 to buy a whole, slow-smoked pig, peach cobbler and other fixings for a barbecue dinner at Dr. Mideis home. Employees from St. Josephs attended the feast. management, Macular That can result in criminal charges and in permanent or temporary loss of the right to bill Medicare for services. Part of this is pure overkill, and part of it is due to some physicians desire to locate patients with the so-called widowmaker lesion significant stenosis in the left main coronary artery before they suffer severe or life threatening events. WebDr. This is becuase many surgeons prefer to operate in the morning, and if these surgeons bring in business, hospital administrators do their best to please them. . If so, let me know, and I can go in and make the fix. Dr. Samin Sharma, MD has a star rating of 4.0/5. Thats a heavy lift in the current fiscal environment. A more practical reason is that doctors are concerned about being sued if they try to Nevertheless, as the Center for Medical Consumers reported in 2006: The number of people undergoing artery-opening procedures continues to rise not only because they are huge money-makers , but they are also very effective at relieving the severe chest pain of angina, which is a common symptom of heart disease. Patients like the quick fix of the stent treatment for angina. I wonder, though, what role defensive medicine plays in the equation as compared to how decisions about how to treat screening test findings are determined in other countries. Doctors Confirm Damar Hamlin Experienced Commotio CordisBut What Is It? policy, Health When a product is very profitable, it is promoted to the skiesand, in such cases manufacturers tend to put the very best face on their clinical research. WebDr. In July 2009, Dr. Sharma launched a monthly live web series, (www.ccclivecases.org), a revolutionary teaching tool in nterventional cardiology globally. thank you Dr Sharma. policy, Press Dr. Sharma completed a residency at Nyi Bd Hospital. Let me add that I dont think that most doctors who recommend procedures using stents are motivated by greed. Were spending a fortune as a country on procedures that people dont need.. As a society, we are getting exactly what we tolerate which as of this writing, includes skyrocketing health care costs, and almost exactly 500 innocent deaths . Sinais Stent star, Cardio Brief, a blog for cardiologists and other cardiovascular health care professionals, heard from Dr. Sharma just last year, shortly after the Brief reported that Columbia University cardiologist Jeffrey Moses had earned $2.5 million in 2006-7, vaulting him to 8th place in the Chronicle of Higher Educations Hit Parade of individuals receiving the highest total compensation at private colleges, 2006- 2007. Apparently Dr. Sharma was miffed. It makes a lot of sense as usual. He currently practices at The Lauder Family Cardiovascular Center and is affiliated with Mount Sinai Beth Israel. Interventional cardiology became a key revenue source for Sinai. The trend toward more hospital employed physicians makes it easier to consolidate vendors and standardize operating room protocols. If a second doctor had to sign off to confirm the need for one or more stents, it would delay treatment and add to the patients anxiety. Sharecare, Editorial WebSamin Sharma; Samin Sharma, M.D. It makes perfect sense. Often, if theyre moving too fast and & consultants, Life See more patient feedback on Sharecare. In other words, governmetn is beginning to regulate prices. Health information on this site is not meant to be used to diagnose or treat conditions. Professional pride plays a role: doctors who implant stents firmly believe that they are helping their patients. Thanks for the commentI am afraid you are entirely right. WebDR SAMIN SHARMA FAMILY FOUNDATION is a tax-exempt organization filed with Internal Revenue Service (IRS). The Individual Mandate: Has the Obama Administration Silently Repealed the Rule that Virtually Everyone Must Have Health Insurance? Below are financial relationships with industry reported by Dr. Sharma during 2022 and/or 2023. | Being, Community On the other side of the coin, stent patients have much higher incidence of problems related to stent failure, re-stenosis, and delayed stent complications, plus face the risk of acute complications, including death, during the procedure. To search within a table, use the box in the upper right corner. Samin Sharma is a cardiologist in New York, New York and is affiliated with Mount Sinai Hospital. That hazingwhich includes being humiliated by people who are supposed to be . B.P. he may find himself in trouble. He also enjoys teaching other cardiologists through the annual live symposium called the Complex Coronary Cases (CCC) Symposium, which is in its 22nd year. Over-Eating: Confusing Cause and EffectDoes Overeating CAUSE You to Re-Gain Weight, Or Do You Eat More BECAUSE You Are Overweight? By the end of 2006 the hospital's total patient revenues had grown 41%, to $1.2 billion.

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