Did you know that your medical treatment may depend on where you live? It even has a name: doctors call it “practice variation”. A new U.S. study suggests, for example, that a person living in St. Cloud, Minnesota is twice as likely to undergo invasive back surgery as a patient with a virtually identical diagnosis living in Rochester. There are a number of reasons for this strange disparity, but one might be that Rochester is the home of the non-profit Mayo Clinic, where surgeons are paid a salary. No matter how many surgeries they do, they earn the same paycheque. But other physicians elsewhere who are paid per surgery may be inclined to do more surgeries.
Such “practice variation” is not just seen at Mayo. Medicare patients in Fort Myers, Florida, are more than twice as likely to receive hip replacement surgeries compared to their counterparts across the Everglades in Miami, according to Dartmouth Health Atlas researchers.
I now sport a shiny stainless steel stent implanted into my left anterior descending coronary artery that was 99% blocked when I survived a heart attack two years ago. Stents are like tiny chicken wire mesh tubes inserted inside the obstructed coronary arteries of your beating heart and then expanded using a small balloon to open blocked arteries that prevent blood flow to heart muscle.
But it appears that some cardiologists like these miraculous little devices so much that they are implanting stents into patients who don’t need them. Continue reading →