Be wary of local cardiologist

[shrink]

I am writing this post to warn others of fraud and abuse which apparently is rampant in Florida. Medicare has established a separate fraud department specifically to investigate Florida claims! Specifically, I saw a cardiologist after my husband was referred to one. It was recommended to me by that cardiologist that I have an initial workup because of my family history and a past hx of smoking. I was asymptomatic, but told that heart disease presents differently in women. Better safe than sorry, right? I was immediately referred for a nuclear stress test (never offered the option of a cardio treadmill stress test). That test cost in excess of $2400., whereas the treadmill test would have been $174.00. Hmmm...never mind, as Medicare and my private insurance were also charged for the treadmill test (which I never had). As a result of the "equivocal" findings on the stress test, it was recommended that I start on Digoxin and also have an invasive angiogram (thousands more) to see what's going on. In the meantime, I was given several other tests, including sonograms, leg studies, etc. which I have since discovered EVERYONE who sees this doctor is given. I decided to seek a second opinion from a reputable cardiologist out of state. That doctor (and I) requested records be sent a total of FIVE times. No records were sent until I called the cardiologist down here and threatened legal action. I now understand why those records weren't sent as requested. It was because there is NOTHING WRONG with my heart, as per my second opinion! By the way, my husband was given all the same tests AND underwent the angiogram...and there was nothing wrong with him, either). My reason for writing this post is to make all Villagers aware of what can go on here. Be sure to carefully check all of your medicare/private insurance statements to see what you've been billed for. Do NOT engage in a ton of tests without getting a second opinion for someone highly reputable. Just because you may not have to pay for those tests directly, we all pay indirectly. Although I'm sure that some of the physicians here are honest, are not referring to establishments where they have financial interests for unnecessary tests or to specialists with whom there is some kind of reciprocity, many are. PLEASE EXERCISE CAUTION.

[Shimpy]

Your caution to be wary of local cardiologist won't help unless you give us a name.

[Lbmb24101]

Yes, who is this dr??

[wendyquat]

You'd be helping us with a name. Please pm me with a name as my husband has recently been put through all these tests and has another appt next week to discuss possible surgery. He has no symptoms! Thanks

[tpop1]

[QUOTE=shrink;561015], I saw a cardiologist after my husband was referred to one. QUOTE]

Without a name, you make us wary of all in the area. That's not fair to the good ones and confusing to those of us who may need to see a cardiologist!

Please share your knowledge. Thanks

[asianthree]

not that i am saying right or wrong but can you run tread for the lengh of time to get your heart rate up ....

[wendyquat]

not that i am saying right or wrong but can you run tread for the lengh of time to get your heart rate up ....

Sure can as I did it with my first stress test. They incline it and speed it up a bit at a time. Took me only a few minutes to get my heart to 135 bpm.

[NotGolfer]

Soooo how do we steer clear of this person?? Don't know their name or where their clinic is located. It's only by word of mouth we can do anything about this collectively.

[Floridagal]

After posting all that, I believe the doctor's name should be told. What is the point of the post if it has no name,

[shrink]

I am reluctant to post a specific name on a public forum. I simply advise that if it seems like too many tests are being run, if you are being told you need a nuclear stress test if in fact you are capable of doing a treadmill test, if the office seems to run like an assembly line, if you overhear one patient after another being scheduled for angiograms, if you get bills which do not reflect what was actually done, etc., steer clear.

[casita37]

Wasn't someone sued recently for posting a bad review about a doctor? I believe it was settled out of court, including an apology from the doctor, but still.....be careful what you say.

The post was not on TOTV, as far as I know, but was in our area, I think.

[shrink]

Please do not press me for a name. I want to help others, but do not want to be sued. Just exercise good judgment and common sense, look for the modus operandi I have reported, and rely heavily on word of mouth from others who have had positive experiences. Also, there is a website called vitals.com. You can go there and type in the name of a doctor and read the comments others have made.

[shrink]

Yes, thank you for understanding.

[ilovetv]

Regarding "I saw a cardiologist after my husband was referred to one. It was recommended to me by that cardiologist that I have an initial workup because of my family history and a past hx of smoking. I was asymptomatic,......"

Why get a heart specialist consult just because your spouse did?

And, where is your primary care doctor's referral in all this?

[shrink]

I sat in with my husband during his exam. The conversation somehow turned to me. And the cardiologist never asked me for a referral from my primary. Just scared me and scheduled me. Then scheduled me some more. Then some more. Then some more. I believe I underwent seven different expensive tests. My primary care doc out of state (whom I trust completely) was shocked when I told him what was done. His comment was, "No wonder insurance costs are so high".

[ilovetv]

I sat in with my husband during his exam. The conversation somehow turned to me. And the cardiologist never asked me for a referral from my primary. Just scared me and scheduled me. Then scheduled me some more. Then some more. Then some more. I believe I underwent seven different expensive tests. My primary care doc out of state (whom I trust completely) was shocked when I told him what was done. His comment was, "No wonder insurance costs are so high".

Did Medicare actually PAY all these claims?

[shrink]

They paid and my secondary paid. Not only did they pay the claims for what was done, they paid for a procedure that was never done! Thousands total!

[graciegirl]

This is a slippery slope. Unless we have a medical degree it is almost impossible to decide what tests are needed and what tests are not needed.

Many medical problems are without symptoms, and when you get to the level of symptoms in cardiovascular illness, such as shortness of breath, blueness, pain, fatigue, swollen ankles,rapid heartbeat, fainting, than you have missed an opportunity to correct some serious problems earlier. Generally there is an ekg, a stress test and then a Thalium stress test and if that discovers something wrong, then a cardiac ultrasound and perhaps a 24 hour Holter monitor and then a cardiac catherization. It is apparent without extensive tests if a person is having some risk factors to further investigate, such as overweight, a sedentary life style and a history of smoking and high cholesteral levels.

It could be that these tests were a scam to make money and it could be that they ascertained that you were alright dispite the risk factor that you mentioned of smoking. This is a very difficult area. I agree with Ilovetv that generally a person is refered to a cardiologist by a primary care physician.

It is wise to check out a physicians background as you say. That in itself is difficult. Even excellent doctors have suits brought against them. There are suit happy people out there. And some not great doctors never get in trouble that is traceable. To figure out who is good, not great and bad in an MD is almost impossible. Large teaching hospitals have very high standards for their physicians and they have ethics committees too and I feel more comfortable with seeking treatment for serious issues by going to a doctor and group associated with a large teaching facility such as Shands in Gainesville or the Mayo Clinic in Jacksonville.

A friend who is himself an MD and lives here in The Villages goes to Shands in Gainesville, for his medical care. I myself trust large teaching hospitals and the doctors associated with them the most because of our frequent experiences with our daughters extensive birth related heart problems.

I am not a medical person..and I am sorry that you, OP had this experience. I think it was very odd you had the Thalium stress test without a regular one first. If you were charged for the plain one and Medicare paid for a test that wasn't performed, that is fraud.

[senior citizen]

......

[senior citizen]

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[senior citizen]

.....

[samhass]

This is a slippery slope. Unless we have a medical degree it is almost impossible to decide what tests are needed and what tests are not needed.

Many medical problems are without symptoms, and when you get to the level of symptoms in cardiovascular illness, such as shortness of breath, blueness, pain, fatigue, swollen ankles,rapid heartbeat, fainting, than you have missed an opportunity to correct some serious problems earlier. Generally there is an ekg, a stress test and then a Thalium stress test and if that discovers something wrong, then a cardiac ultrasound and perhaps a 24 hour Holter monitor and then a cardiac catherization. It is apparent without extensive tests if a person is having some risk factors to further investigate, such as overweight, a sedentary life style and a history of smoking and high cholesteral levels.

It could be that these tests were a scam to make money and it could be that they ascertained that you were alright dispite the risk factor that you mentioned of smoking. This is a very difficult area. I agree with Ilovetv that generally a person is refered to a cardiologist by a primary care physician.

It is wise to check out a physicians background as you say. That in itself is difficult. Even excellent doctors have suits brought against them. There are suit happy people out there. And some not great doctors never get in trouble that is traceable. To figure out who is good, not great and bad in an MD is almost impossible. Large teaching hospitals have very high standards for their physicians and they have ethics committees too and I feel more comfortable with seeking treatment for serious issues by going to a doctor and group associated with a large teaching facility such as Shands in Gainesville or the Mayo Clinic in Jacksonville.

A friend who is himself an MD and lives here in The Villages goes to Shands in Gainesville, for his medical care. I myself trust large teaching hospitals and the doctors associated with them the most because of our frequent experiences with our daughters extensive birth related heart problems.

I am not a medical person..and I am sorry that you, OP had this experience. I think it was very odd you had the Thalium stress test without a regular one first. If you were charged for the plain one and Medicare paid for a test that wasn't performed, that is fraud.

Well said, Gracie.:highfive:

[senior citizen]

Well said, Gracie.:highfive:

Teaching hospitals are an excellent choice as Gracie said in earlier post.
However, even they use trials and experimental type procedures that they no doubt know might not end in a happy way for the patient.

We have a family member who was given an extended five years of life via great care and experimental treatment at DUKE UNIVERSITY in N.C. for liver cancer. However, they've now been told they have dementia as a result of the treatment. Early 50 years old and has been told the cancer is chronic but treatable with radioactive isotopes?? However, she has had to seek early retirement and go on disability via medicare. Duke is a great teaching hospital. Very forgetfull and unable to work as a result of the treatment.

Ditto for Dartmouth in Hanover, New Hampshire......to which many of our townsfolk go for their cancers. Lots of experimental treatments.
It may "buy time" but ultimately most are dying eventually. It's sad to see....esp. among the young women in their 40's........all doctors are well aware that the chemo is poison to healthy cells as well as the cancer cells. We know people who've lost all feeling in their hands and feet; neuropathy, due to treatment. It will never return.

We do have an oncology center as part of our hospital, but for the more aggressive types, they send them to Dartmouth or to Boston....or even Mount Sinai in New York City. It's been a sad ending for all of them and their families.

When my mother in law had cancer back in 1970 (and years prior) there was no treatment at all.....she eventually did pass, with no pain at all.
Was able to function up to the end. Painless death. At the time, the family was told that her many cancers were caused by early xray treatment given to her during her pregnancies........30 years prior.

[graciegirl]

Teaching hospitals are an excellent choice as Gracie said in earlier post.
However, even they use trials and experimental type procedures that they no doubt know might not end in a happy way for the patient.

We have a family member who was given an extended five years of life via great care and experimental treatment at DUKE UNIVERSITY in N.C. for liver cancer. However, they've now been told they have dementia as a result of the treatment. Early 50 years old and has been told the cancer is chronic but treatable with radioactive isotopes?? However, she has had to seek early retirement and go on disability via medicare. Duke is a great teaching hospital. Very forgetfull and unable to work as a result of the treatment.

Ditto for Dartmouth in Hanover, New Hampshire......to which many of our townsfolk go for their cancers. Lots of experimental treatments.
It may "buy time" but ultimately most are dying eventually. It's sad to see....esp. among the young women in their 40's........all doctors are well aware that the chemo is poison to healthy cells as well as the cancer cells. We know people who've lost all feeling in their hands and feet; neuropathy, due to treatment. It will never return.

We do have an oncology center as part of our hospital, but for the more aggressive types, they send them to Dartmouth or to Boston....or even Mount Sinai in New York City. It's been a sad ending for all of them and their families.

When my mother in law had cancer back in 1970 (and years prior) there was no treatment at all.....she eventually did pass, with no pain at all.
Was able to function up to the end. Painless death. At the time, the family was told that her many cancers were caused by early xray treatment given to her during her pregnancies........30 years prior.

Senior.

Helene and I are cancer survivors and what you say is true...HOWEVER a person is not given experimental treatment as a matter of course. The risks are carefully explained and most people who receive treatment in these studies have been on a waiting list and carefully evaluated and usually because all other options have not been successful in stopping their cancers.

Chemo does kill healthy cells and people do get other side effects from chemo but at this point it is what we have to save lives.

Helene and I feel very fortunate to still be here. Cancer is survivable.

There are horror stories about radiation that was used in the 40's thinking it would help. Much more is known about radiation today and although there is still a risk factor, it too is a tool in saving people.

When we are diagnosed with a serious disease we need to expend every effort to find the best place to treat the disease and try to continue to live the life we are given.

[shrink]

Thanks for your good advice, Graciegirl. Well said and things to keep in mind. I do like the idea of Shands, and if we ever NEED serious intervention, that is where we will go!

[shrink]

Well said, Gracie.:highfive:

Yes indeed, it is fraud. I believe the reason I was charged for both was to "justify" to insurance the reason for giving the nuclear stress test, i.e., "tried the treadmill, couldn't complete, had to give thallium". This has been reported to both Medicare and my private insurance company which paid for all. Interestingly, when I tried to tell Medicare about everything that was done without medical necessity, they were unable to investigate anything other than the bogus charge. I did go on the site Vitals.com under the doctor's name and found other such complaints against him. Although anyone can go on that site and leave comments (such as the doctor himself, his family, his friends, etc.), its still a wise idea to look there before going to anyone new. Thanks for writing.

[gemorc]

Sorry Shrink, I do not understand. By not posting this doctors name, you cast aspersions on all LOCAL cardiologists. Maybe it is my doctor, I don't know. If you are going to post a thread like this, have the nerve to state the facts.

[Villages PL]

They paid and my secondary paid. Not only did they pay the claims for what was done, they paid for a procedure that was never done! Thousands total!

The problem might have started when the doctor found out that you had secondary insurance. He thought, "Wow, I'll be able to talk her into all kinds of expensive tests and she'll go for it. Ca-ching! $$$$$$"

I don't blame you, I blame the doctor. But I think it's all too easy for the patient to be trusting when cost is not a factor. If you had to pay 20% you might not have been so trusting.

[Villages PL]

Sorry Shrink, I do not understand. By not posting this doctors name, you cast aspersions on all LOCAL cardiologists. Maybe it is my doctor, I don't know. If you are going to post a thread like this, have the nerve to state the facts.

All heart patients should be warry of all heart doctors, in my opinion. Most of them (again my opinion) will never give the option of lifestyle changes to reverse coronary artery disease. They are in business to make money and placing stints or giving by pass surgery pays a heck of a lot more than giving someone a stern warning and a diet/exercise plan.

[graciegirl]

All heart patients should be warry of all heart doctors, in my opinion. Most of them (again my opinion) will never give the option of lifestyle changes to reverse coronary artery disease. They are in business to make money and placing stints or giving by pass surgery pays a heck of a lot more than giving someone a stern warning and a diet/exercise plan.

I disagree.

[ilovetv]

All heart patients should be warry of all heart doctors, in my opinion. Most of them (again my opinion) will never give the option of lifestyle changes to reverse coronary artery disease. They are in business to make money and placing stints or giving by pass surgery pays a heck of a lot more than giving someone a stern warning and a diet/exercise plan.

BULL-Oney!!!! Non-Invasive Cardiologists do not do these surgeries. They are trained in internal medicine first and are not surgeons.

You paint with a broad brush the very professionals people need both before and during a life-threatening disease/condition.

[caseylou5]

You could save someone's life by posting the name of the Dr. It would appear that he or she is only in the practice for the money. If he or she is worth their salt they can defend themselves,

This is one of the reasons our Healtcare costs continues to climb. Needless tests only hurt the patient and feed the Doctors.

[graciegirl]

All heart patients should be warry of all heart doctors, in my opinion. Most of them (again my opinion) will never give the option of lifestyle changes to reverse coronary artery disease. They are in business to make money and placing stints or giving by pass surgery pays a heck of a lot more than giving someone a stern warning and a diet/exercise plan.


You are again, in my opinion, proceeding from inaccurate information.

Here is the index page from The Mayo Clinic's book. Heart Healthy for Life.

They are first interested in life changes, stepping up exercise and changing your diet.


Mayo Clinic Healthy Heart for Life
https://store.mayoclinic.com/BMC/images/books/293400/previews/293400_02.jpg

[graciegirl]

All heart patients should be warry of all heart doctors, in my opinion. Most of them (again my opinion) will never give the option of lifestyle changes to reverse coronary artery disease. They are in business to make money and placing stints or giving by pass surgery pays a heck of a lot more than giving someone a stern warning and a diet/exercise plan.


And here is from preventative health information page from The Cleveland Clinic, The Best in the country for problems with the heart and cardiovascular system
Heart & Vascular Health and Prevention


Preventive Cardiology and Rehabilitation

The Section of Preventive Cardiology and Rehabilitation (http://my.clevelandclinic.org/heart/departments-centers/preventive-cardiology-rehabilitation.aspx) helps those who already have heart and vascular disease and those who are at high risk of developing it.
Individualized & Group Prevention Programs

Preventive Cardiology and Rehabilitation (http://my.clevelandclinic.org/heart/departments-centers/preventive-cardiology-rehabilitation.aspx) offers a multidisciplinary approach to preventing the occurrence or progression of cardiovascular disease: nutritional services, prescriptive exercise programs, stress testing, multiple cardiovascular risk reduction programs, peripheral vascular rehabilitation program in collaboration with Vascular Medicine, comprehensive cardiovascular care for women, and educational programs for patients and healthcare providers.

Learn about Hot Topics in Prevention by our Prevention experts (http://my.clevelandclinic.org/heart/prevention/hot_topics_in_preventive_cardiology.aspx)
Nutrition Services


Learn about our remote nutrition counseling (http://www.eclevelandclinic.org/productHome.jsp?productId=nutrition) or our on-site Nutrition Program (http://my.clevelandclinic.org/heart/departments-centers/preventive-cardiology-rehabilitation.aspx#tab-6)
Try our great recipes (http://my.clevelandclinic.org/heart/prevention/nutrition/recipes/heart_healthy_recipes.aspx)
Learn what's new in nutrition news (http://my.clevelandclinic.org/heart/prevention/nutrition/news/default.aspx) - New!
Diet and Nutrition Information: Nutrition Strategies (http://my.clevelandclinic.org/heart/prevention/nutrition/Pages/default.aspx)
Group Exercise Programs and Individual Exercise Consultation


Exercise to good health: Exercise Information (http://my.clevelandclinic.org/heart/prevention/exercise/default.aspx)
Specialized Programs for Women and Teens


Learn more about Women's Cardiovascular Health (http://my.clevelandclinic.org/heart/departments-centers/womens-cardiovascular-center.aspx)
Pediatric Preventive Cardiology and Metabolic Clinic (http://my.clevelandclinic.org/heart/departments-centers/preventive-cardiology-rehabilitation.aspx#tab-6)
Learn More About These Prevention Topics:


Cholesterol (http://my.clevelandclinic.org/heart/prevention/cholesterol/default.aspx)
High Blood Pressure (http://my.clevelandclinic.org/disorders/Hypertension_High_Blood_Pressure/Pages/hic_Preventing_Hypertension.aspx)
Integrative- Healing Heart Therapies (http://my.clevelandclinic.org/heart/prevention/alternative/default.aspx)
Weight Management (http://my.clevelandclinic.org/heart/prevention/weight_management/Pages/default.aspx)
Diabetes (http://my.clevelandclinic.org/heart/prevention/diabetes/default.aspx)
Evaluation of Risk Factors (http://my.clevelandclinic.org/heart/prevention/framingham.aspx)
Stress & Emotion (http://my.clevelandclinic.org/heart/prevention/stress/default.aspx)
Women & Prevention (http://my.clevelandclinic.org/heart/departments-centers/womens-cardiovascular-center.aspx)
Web Chats


Read transcripts of past web chats (http://my.clevelandclinic.org/heart/webchat/default.aspx)
Interactive Tools


Take the cholesterol quiz (http://my.clevelandclinic.org/health/tools.aspx)
Body Mass Index Calculator (http://my.clevelandclinic.org/heart/prevention/weight/bmi.aspx)
Reviewed: 08/12


.

[graciegirl]

Wendy.

The Cleveland Clinic doesn't have a branch here, but if there is a problem you can fly there as my oldest friend's husband did from Huntsville, Alabama. The local doctors didn't know how else to help him.

He is doin' fine these seven years later.

.

[wendyquat]

Gracie, you are so wise and I appreciate your comments! I'm so glad you and Helene are survivors! I'd bet your sunny, sensible attitude had a lot to do with that!

Can anyone tell me if you have to be referred to Shands, do they accept Medicare and is there a cardiologist there you would recommend?

The only Cleveland Clinic I see in Fla is West Palm Beach and that is a little far. It seems Mayo does not participate in Medicare and that would be a must for us!

[mrsyarbie]

I don't understand, if you had no symptoms what prompted you to seek a cardiologist? Did you have angina? or shortness of breath? did you have fainting spells ?? feelings of discomfort when you exert yourself, you said you were asymptomatic but angina comes in many forms not just chest pain so I find your remarks confusing... I worked for USF Health Cardiology for 16 years and can recommend many excellant cardiologists just 90 minutes away if you like.A nuclear test is done rather than a treadmill test for many reasons for example because heavy smokers usually tire out and develop shortness breath before the test can be completed properly and diagnosed , or also in cases of obesity. Hope if you have any type of cardiac related disease like hypertension you will continue to seek care..

[mrsyarbie]

:pepper2:And here is from preventative health information page from The Cleveland Clinic, The Best in the country for problems with the heart and cardiovascular system
Heart & Vascular Health and Prevention


Preventive Cardiology and Rehabilitation

The Section of Preventive Cardiology and Rehabilitation (http://my.clevelandclinic.org/heart/departments-centers/preventive-cardiology-rehabilitation.aspx) helps those who already have heart and vascular disease and those who are at high risk of developing it.
Individualized & Group Prevention Programs

Preventive Cardiology and Rehabilitation (http://my.clevelandclinic.org/heart/departments-centers/preventive-cardiology-rehabilitation.aspx) offers a multidisciplinary approach to preventing the occurrence or progression of cardiovascular disease: nutritional services, prescriptive exercise programs, stress testing, multiple cardiovascular risk reduction programs, peripheral vascular rehabilitation program in collaboration with Vascular Medicine, comprehensive cardiovascular care for women, and educational programs for patients and healthcare providers.

Learn about Hot Topics in Prevention by our Prevention experts (http://my.clevelandclinic.org/heart/prevention/hot_topics_in_preventive_cardiology.aspx)
Nutrition Services


Learn about our remote nutrition counseling (http://www.eclevelandclinic.org/productHome.jsp?productId=nutrition) or our on-site Nutrition Program (http://my.clevelandclinic.org/heart/departments-centers/preventive-cardiology-rehabilitation.aspx#tab-6)
Try our great recipes (http://my.clevelandclinic.org/heart/prevention/nutrition/recipes/heart_healthy_recipes.aspx)
Learn what's new in nutrition news (http://my.clevelandclinic.org/heart/prevention/nutrition/news/default.aspx) - New!
Diet and Nutrition Information: Nutrition Strategies (http://my.clevelandclinic.org/heart/prevention/nutrition/Pages/default.aspx)
Group Exercise Programs and Individual Exercise Consultation


Exercise to good health: Exercise Information (http://my.clevelandclinic.org/heart/prevention/exercise/default.aspx)
Specialized Programs for Women and Teens


Learn more about Women's Cardiovascular Health (http://my.clevelandclinic.org/heart/departments-centers/womens-cardiovascular-center.aspx)
Pediatric Preventive Cardiology and Metabolic Clinic (http://my.clevelandclinic.org/heart/departments-centers/preventive-cardiology-rehabilitation.aspx#tab-6)
Learn More About These Prevention Topics:


Cholesterol (http://my.clevelandclinic.org/heart/prevention/cholesterol/default.aspx)
High Blood Pressure (http://my.clevelandclinic.org/disorders/Hypertension_High_Blood_Pressure/Pages/hic_Preventing_Hypertension.aspx)
Integrative- Healing Heart Therapies (http://my.clevelandclinic.org/heart/prevention/alternative/default.aspx)
Weight Management (http://my.clevelandclinic.org/heart/prevention/weight_management/Pages/default.aspx)
Diabetes (http://my.clevelandclinic.org/heart/prevention/diabetes/default.aspx)
Evaluation of Risk Factors (http://my.clevelandclinic.org/heart/prevention/framingham.aspx)
Stress & Emotion (http://my.clevelandclinic.org/heart/prevention/stress/default.aspx)
Women & Prevention (http://my.clevelandclinic.org/heart/departments-centers/womens-cardiovascular-center.aspx)
Web Chats


Read transcripts of past web chats (http://my.clevelandclinic.org/heart/webchat/default.aspx)
Interactive Tools


Take the cholesterol quiz (http://my.clevelandclinic.org/health/tools.aspx)
Body Mass Index Calculator (http://my.clevelandclinic.org/heart/prevention/weight/bmi.aspx)
Reviewed: 08/12


.

[CaptJohn]

This has been a very educational thread. Sure are a lot of knowledgeable people on TOTV! Thanks for sharing.

[Carl in Tampa]

You confuse me.

A nuclear stress test can be executed either on a treadmill or through the use of chemical stimulation of your heart. It all depends upon whether you are physically capable of exercising on the treadmill long enough to get your heart to the target heart rate.

In either case, treadmill or chemical, the thing that makes it a nuclear stress test is based upon the injection of nuclear material into your blood stream before the test begins.

You condemn an office that is "run like an assembly line." Couldn't that also be characterized as simply being well organized and efficient?

You say that one should steer clear if you get bills that do not reflect what was actually done. By then it's too late to steer clear.

Your original post, although possibly well meaning, is totally valueless because of your failure to provide the name of the doctor.

Perhaps you could have simply recommended that people should check out that doctor by name on the web site where you say others have criticized him.

[Carl in Tampa]

All heart patients should be warry of all heart doctors, in my opinion. Most of them (again my opinion) will never give the option of lifestyle changes to reverse coronary artery disease. They are in business to make money and placing stints or giving by pass surgery pays a heck of a lot more than giving someone a stern warning and a diet/exercise plan.

I disagree. My cardiologists have always encouraged me to modify my lifestyle (usually by losing weight and exercising) to control my blood pressure and protect my heart.

Here in TV I go to Dr. Georg Couturier at Heart of The Villages in Spanish Springs. On my first office visit he spent one hour with me explaining my heart condition to me and detailing what I must do to avoid further damage to my heart. He did this while he had several other patients in the waiting room and his reimbursement was at the Medicare rate which actually pays for an office visit of under 15 minutes.

The man is a gem!

[BBQMan]

GG, I applaud your support of Physicians you believe to be capable. Unfortunately, in my experience, they are not. We draw the physicians who cannot make a living in anything other than a Medicare environment. In my case, I had a heart problem that required a pacemaker. The pacemaker was installed, (put in place) by a surgeon in a large cardiac practice, with a Villages office. The procedure was done at LRMC. Nothing got better. I had a series of tests over the next few months. Action resulting - zero. Choosing to try to live, I went to Mayo Clinic in Jacksonville. The initial office exam showed that my pacemaker was not working correctly. The Medtronic rep confirmed this.

Initial surgery was done to repair the pacemaker. Surgery showed that (1) one of the two leads was never attached; (2) the other lead had very high impedance; and (3) it was not the right pacemaker to start with. The surgeon, at a subsequent operation put in place a three lead, biventricular pacemaker. I'm doing well now, thanks to Mayo and in no way thanks to to the local cardiologists. If it were up to them, I'd be dead.

I had a similar experienced with my wife. She fell and broke her hip. I interrupted the surgery to discover that after 45 minutes, they did not have an IV capable of providing the need meds to her. If this is not incompetence, please define it for me.

My encouragement to my fellow Villagers is (1) if you need a flu shot go to you local doctor; (2) if you have any reason to believe your may seriously ill – get out of town! The physicians in the Villages settled here either to retire or because they were not accepted as competent by their peers. No one came here to blaze new trails or be a leader in their specialty.

[SALYBOW]

Maybe I can help. Go to Dr. George Couterier and avoid all this. You get the best of the best at the same time.

[graciegirl]

GG, I applaud your support of Physicians you believe to be capable. Unfortunately, in my experience, they are not. We draw the physicians who cannot make a living in anything other than a Medicare environment. In my case, I had a heart problem that required a pacemaker. The pacemaker was installed, (put in place) by a surgeon in a large cardiac practice, with a Villages office. The procedure was done at LRMC. Nothing got better. I had a series of tests over the next few months. Action resulting - zero. Choosing to try to live, I went to Mayo Clinic in Jacksonville. The initial office exam showed that my pacemaker was not working correctly. The Medtronic rep confirmed this.

Initial surgery was done to repair the pacemaker. Surgery showed that (1) one of the two leads was never attached; (2) the other lead had very high impedance; and (3) it was not the right pacemaker to start with. The surgeon, at a subsequent operation put in place a three lead, biventricular pacemaker. I'm doing well now, thanks to Mayo and in no way thanks to to the local cardiologists. If it were up to them, I'd be dead.

I had a similar experienced with my wife. She fell and broke her hip. I interrupted the surgery to discover that after 45 minutes, they did not have an IV capable of providing the need meds to her. If this is not incompetence, please define it for me.

My encouragement to my fellow Villagers is (1) if you need a flu shot go to you local doctor; (2) if you have any reason to believe your may seriously ill – get out of town! The physicians in the Villages settled here either to retire or because they were not accepted as competent by their peers. No one came here to blaze new trails or be a leader in their specialty.

I don't think I said anything in support of any local medical institution. I haven't consulted anyone here for cancer or heart, we return to Cincinnati for those continued medical evaluations. I have no experience with local hospitals. We see a GP here.

[784caroline]

All heart patients should be warry of all heart doctors, in my opinion. Most of them (again my opinion) will never give the option of lifestyle changes to reverse coronary artery disease. They are in business to make money and placing stints or giving by pass surgery pays a heck of a lot more than giving someone a stern warning and a diet/exercise plan.

DISAGREE ....DISAGREE a post like this is a disservice to all. There are good and bad Doctors in all fields and each individual doctor has his/her standard method of diagonsis. Yes they do make money ...why shouldnt they....but if I need a heart DR. hopefully I will select one based on referrals/recommendations.

Gracies comments are right on.....

[mrsanborn]

GG, I applaud your support of Physicians you believe to be capable. Unfortunately, in my experience, they are not. We draw the physicians who cannot make a living in anything other than a Medicare environment. In my case, I had a heart problem that required a pacemaker. The pacemaker was installed, (put in place) by a surgeon in a large cardiac practice, with a Villages office. The procedure was done at LRMC. Nothing got better. I had a series of tests over the next few months. Action resulting - zero. Choosing to try to live, I went to Mayo Clinic in Jacksonville. The initial office exam showed that my pacemaker was not working correctly. The Medtronic rep confirmed this.

Initial surgery was done to repair the pacemaker. Surgery showed that (1) one of the two leads was never attached; (2) the other lead had very high impedance; and (3) it was not the right pacemaker to start with. The surgeon, at a subsequent operation put in place a three lead, biventricular pacemaker. I'm doing well now, thanks to Mayo and in no way thanks to to the local cardiologists. If it were up to them, I'd be dead.

I had a similar experienced with my wife. She fell and broke her hip. I interrupted the surgery to discover that after 45 minutes, they did not have an IV capable of providing the need meds to her. If this is not incompetence, please define it for me.

My encouragement to my fellow Villagers is (1) if you need a flu shot go to you local doctor; (2) if you have any reason to believe your may seriously ill – get out of town! The physicians in the Villages settled here either to retire or because they were not accepted as competent by their peers. No one came here to blaze new trails or be a leader in their specialty.

I too had an ICD/Pacemaker implanted at LRMC. I also felt the care I received at LRMC was of very high quality. What I don't understand through your experience is why didn't the Medtronics tech find these problems at the time of the implantation? The device is tested either the day of implantation or the very next day.

I would have think that you have a giant malpractice suit going on against this Village practice and the surgeon that preformed the operation. So, have your attorney's issued a gag order or are you going to name names?

Your number 2 is quite a statement. My cardiologist is Dr. Brian Saluck who I would highly recommend. He is in his 40's and has a very impressive bio so I don't believe he came here to retire just yet.

[BBQMan]

I'm glad to know that you were satisfied with the treatment you received and the outcome was good. As for a lawsuit, I've been involved in two of them (neither medically connected) and came out of them never wanting to be involved in one again although I did 'win' in both cases. The truth of the matter is that the attorneys won as they do in most suits. Life is too short to waste it on things that really do not matter.

I maintain that my advice to get out of The Villages is valid. Even if you have a great physician, the requisite support does not exist here. Ask yourself the question, "If my physician is as good as I believe, why isn't he/she practicing in a major medical center?"

[Shimpy]

I don't think I said anything in support of any local medical institution. I haven't consulted anyone here for cancer or heart, we return to Cincinnati for those continued medical evaluations. I have no experience with local hospitals. We see a GP here.

You sound like my uncle who used to visit us once a year in Miami when I was a kid. If he had any need for a doctor he would cut his visit short and catch the next plane to Pittsburgh because that was the only place to get good doctors. One year he left the next day after arriving because he got a toothache.

[shrink]

oic

[shrink]

Sorry Shrink, I do not understand. By not posting this doctors name, you cast aspersions on all LOCAL cardiologists. Maybe it is my doctor, I don't know. If you are going to post a thread like this, have the nerve to state the facts.

Well, if you are willing to pay my legal expenses if I post this doctor's name and am sued for slander, please let me know that. Give me access to your bank account, and I'll gladly do as you suggest. Maybe if you would read my description of what happened, along with my suggestion to check internet sites such as vitals.com, you could be a bit more informed and protected. Why do you think I posted? It was to save people such as yourself from having a similar experience. Best of luck.

[Villages PL]

BULL-Oney!!!! Non-Invasive Cardiologists do not do these surgeries. They are trained in internal medicine first and are not surgeons.

You paint with a broad brush the very professionals people need both before and during a life-threatening disease/condition.

I clearly stated "most of them", not all of them, and I stand by my statement. Cardiologists are trained for both but the only difference is the non-invasive approach does not employ catheters, ballons, and stents.

They are in business, just like any other business, to make money.

The pharmacist on this site agrees with me as he once pointed out that doctors [more often than not] choose to protect their butts by overtreating their patients (rather than relying on natural means). So, I repeat, be warry of all heart doctors.

[Villages PL]

DISAGREE ....DISAGREE a post like this is a disservice to all. There are good and bad Doctors in all fields and each individual doctor has his/her standard method of diagonsis. Yes they do make money ...why shouldnt they....but if I need a heart DR. hopefully I will select one based on referrals/recommendations.

I DISAGREE.....DISAGREE.....DISAGREE. (My three "DISAGREES" beat your two disagrees) :wave:

My post is not a disservice because it warns people to be cautious (as apposed to uncautious and laxidasical) No one should go through life blindly trusting everyone. We all know there are good and bad doctors; that's why people need to be warry of all doctors. One can never know for sure whether a doctor will turn out to be good or bad, even with a friend's recommendation.

[Villages PL]

You are again, in my opinion, proceeding from inaccurate information.

Here is the index page from The Mayo Clinic's book. Heart Healthy for Life.

They are first interested in life changes, stepping up exercise and changing your diet.


Mayo Clinic Healthy Heart for Life
https://store.mayoclinic.com/BMC/images/books/293400/previews/293400_02.jpg

Yes, but that's a book, not a doctor. My local library is full of good books and some of them are about heart care.

[Villages PL]

And here is from preventative health information page from The Cleveland Clinic, The Best in the country for problems with the heart and cardiovascular system
Heart & Vascular Health and Prevention


Preventive Cardiology and Rehabilitation

The Section of Preventive Cardiology and Rehabilitation (http://my.clevelandclinic.org/heart/departments-centers/preventive-cardiology-rehabilitation.aspx) helps those who already have heart and vascular disease and those who are at high risk of developing it.
Individualized & Group Prevention Programs

Preventive Cardiology and Rehabilitation (http://my.clevelandclinic.org/heart/departments-centers/preventive-cardiology-rehabilitation.aspx) offers a multidisciplinary approach to preventing the occurrence or progression of cardiovascular disease: nutritional services, prescriptive exercise programs, stress testing, multiple cardiovascular risk reduction programs, peripheral vascular rehabilitation program in collaboration with Vascular Medicine, comprehensive cardiovascular care for women, and educational programs for patients and healthcare providers.

Learn about Hot Topics in Prevention by our Prevention experts (http://my.clevelandclinic.org/heart/prevention/hot_topics_in_preventive_cardiology.aspx)
Nutrition Services


Learn about our remote nutrition counseling (http://www.eclevelandclinic.org/productHome.jsp?productId=nutrition) or our on-site Nutrition Program (http://my.clevelandclinic.org/heart/departments-centers/preventive-cardiology-rehabilitation.aspx#tab-6)
Try our great recipes (http://my.clevelandclinic.org/heart/prevention/nutrition/recipes/heart_healthy_recipes.aspx)
Learn what's new in nutrition news (http://my.clevelandclinic.org/heart/prevention/nutrition/news/default.aspx) - New!
Diet and Nutrition Information: Nutrition Strategies (http://my.clevelandclinic.org/heart/prevention/nutrition/Pages/default.aspx)
Group Exercise Programs and Individual Exercise Consultation


Exercise to good health: Exercise Information (http://my.clevelandclinic.org/heart/prevention/exercise/default.aspx)
Specialized Programs for Women and Teens


Learn more about Women's Cardiovascular Health (http://my.clevelandclinic.org/heart/departments-centers/womens-cardiovascular-center.aspx)
Pediatric Preventive Cardiology and Metabolic Clinic (http://my.clevelandclinic.org/heart/departments-centers/preventive-cardiology-rehabilitation.aspx#tab-6)
Learn More About These Prevention Topics:


Cholesterol (http://my.clevelandclinic.org/heart/prevention/cholesterol/default.aspx)
High Blood Pressure (http://my.clevelandclinic.org/disorders/Hypertension_High_Blood_Pressure/Pages/hic_Preventing_Hypertension.aspx)
Integrative- Healing Heart Therapies (http://my.clevelandclinic.org/heart/prevention/alternative/default.aspx)
Weight Management (http://my.clevelandclinic.org/heart/prevention/weight_management/Pages/default.aspx)
Diabetes (http://my.clevelandclinic.org/heart/prevention/diabetes/default.aspx)
Evaluation of Risk Factors (http://my.clevelandclinic.org/heart/prevention/framingham.aspx)
Stress & Emotion (http://my.clevelandclinic.org/heart/prevention/stress/default.aspx)
Women & Prevention (http://my.clevelandclinic.org/heart/departments-centers/womens-cardiovascular-center.aspx)
Web Chats


Read transcripts of past web chats (http://my.clevelandclinic.org/heart/webchat/default.aspx)
Interactive Tools


Take the cholesterol quiz (http://my.clevelandclinic.org/health/tools.aspx)
Body Mass Index Calculator (http://my.clevelandclinic.org/heart/prevention/weight/bmi.aspx)
Reviewed: 08/12


.

Lots of information but I didn't find anywhere to "click on" to find out their diet recommendations for reversing coronary artery disease. So that leaves me skeptical. In my mind it means the clinic doesn't want to do anything that substantive which could potentially take business away from doctors.

[Villages PL]

Deleted duplicate post

[rubicon]

The OP comments are instructive concerning the need for each of us to be good consumers of medical services and products. it also is instructive as to te conflict presented to health carriers. simply stated trying to determine which medical professions are ordering unnecessary and/or over priced testing, drugs, therapies, etc.

Medical professionals like all of us are in business to make a living but also charged with our care. Most are good caring people.

I left myprimary care doc here because he in my opinion was ordering unnecessary testing ,etc. Conversely, I have a cardiologist that substitutes as my primary care doc and he is very professional and caring.

Conversely I can tell you that I had the number one surgeon in the State of Minnesota in his field. A surgeon my specialist, who was also listed as the number one in the State in his field, said was the surgeon doctors go to for care

I won't bore you with details, but Ttis number one surgeon almost killed me leaing me in what was termed grave conditions and left me in hopsital care for 31 days, the need for a drug induced coma and 4 months of rhab at home.

Speak up when at the docotr's office for both of your benefits.

[Shirleevee]

I too had an ICD/Pacemaker implanted at LRMC. I also felt the care I received at LRMC was of very high quality. What I don't understand through your experience is why didn't the Medtronics tech find these problems at the time of the implantation? The device is tested either the day of implantation or the very next day.

I would have think that you have a giant malpractice suit going on against this Village practice and the surgeon that preformed the operation. So, have your attorney's issued a gag order or are you going to name names?

Your number 2 is quite a statement. My cardiologist is Dr. Brian Saluck who I would highly recommend. He is in his 40's and has a very impressive bio so I don't believe he came here to retire just yet.

We are from NY where health care is excellent. My husband had a stent done here by a Cardiologist we liked very much and one year later surgery for and AAA.....we liked the Thoracic surgeon too.....not every great doctor can work at the Cleveland Clinic or Columbia Pres........in our experience, there are great doctors everywhere. JMHO

[shrink]

Carl, thanks for writing. I need to tell you that in this case, "runs like an assembly line" does NOT represent a well organized and efficient office. My cardiologist up North and I requested FIVE TIMES that records be sent. It wasn't until I threatened legal action that the records were sent. Of course, they showed no problem, no need for further investigation, etc. That's the reason the requests were ignored in the first place. You're right...after the fact billing IS too late. And re: the treadmill test, there was absolutely no reason why I couldn't have taken that test. I quit smoking 25 years ago, am not obese, etc. I was never given the option, nor from what I could see, is anyone else who is a patient there. Your point that I should have directed others to vitals.com is very well taken, and I will do that in the future should I run across (heaven forbid) another such practitioner. Thanks again.

[shrink]

You confuse me.

A nuclear stress test can be executed either on a treadmill or through the use of chemical stimulation of your heart. It all depends upon whether you are physically capable of exercising on the treadmill long enough to get your heart to the target heart rate.

In either case, treadmill or chemical, the thing that makes it a nuclear stress test is based upon the injection of nuclear material into your blood stream before the test begins.

You condemn an office that is "run like an assembly line." Couldn't that also be characterized as simply being well organized and efficient?

You say that one should steer clear if you get bills that do not reflect what was actually done. By then it's too late to steer clear.

Your original post, although possibly well meaning, is totally valueless because of your failure to provide the name of the doctor.

Perhaps you could have simply recommended that people should check out that doctor by name on the web site where you say others have criticized him.

I don't understand, if you had no symptoms what prompted you to seek a cardiologist? Did you have angina? or shortness of breath? did you have fainting spells ?? feelings of discomfort when you exert yourself, you said you were asymptomatic but angina comes in many forms not just chest pain so I find your remarks confusing... I worked for USF Health Cardiology for 16 years and can recommend many excellant cardiologists just 90 minutes away if you like.A nuclear test is done rather than a treadmill test for many reasons for example because heavy smokers usually tire out and develop shortness breath before the test can be completed properly and diagnosed , or also in cases of obesity. Hope if you have any type of cardiac related disease like hypertension you will continue to seek care..

Hello. If you read the entire thread, you would understand why I initially agreed to have some tests done. The doctor scared me half to death! The conversation came up while my husband was being tested (and by the way, also without symptoms, but had been referred by another "good ol' boy"...."just to be on the safe side"). I was advised that it would be in my best interest due to a past ( I quit 25 years ago) hx of smoking and a family history of heart disease. However, I had and have no symptoms. I was told that I could drop dead any second even without symptoms. It has since dawned on me that I can be stuck by a car, lightning, or a wayward crane bucket and die without any warning, too. Should I be tested for being in the wrong place at the wrong time? This was not good medicine; it was simply a means for lining the pocket of a greedy and unscrupulous individual (IMHO!).

[sandybill2]

I worked in Cardiology office for 30+ years---started out assisting and at the time of my retirement was the Business Office Manager. The charge you saw for 174.00 for treadmill test that you said you didn't actually have was probably for supplies. When billing is done--each and every component of the test has a separate CPT code (this is a universal code that tells the insurance companies what is being billed) I am guessing that this code and charge was probably for supplies---maybe even the Nuclear infusion that was done. Can't be sure but I would imagine if you went to the Cardiology office for a Cardiostress test the charge would be more than 174.00.

[shrink]

I worked in Cardiology office for 30+ years---started out assisting and at the time of my retirement was the Business Office Manager. The charge you saw for 174.00 for treadmill test that you said you didn't actually have was probably for supplies. When billing is done--each and every component of the test has a separate CPT code (this is a universal code that tells the insurance companies what is being billed) I am guessing that this code and charge was probably for supplies---maybe even the Nuclear infusion that was done. Can't be sure but I would imagine if you went to the Cardiology office for a Cardiostress test the charge would be more than 174.00.

Thanks for writing and I appreciate your expertise. The CPT code was 93015, "Cardio treadmill stress test w/EKG, with MD" (which I never had). The "supplies" that you mentioned: Myocardial perfusion imaging ($982.00), Injection, regadenoson ($408.00) and Technetium tc-99m sestamibi, DX, study dose ($944.00) referenced the thallium stress test, which was the only stress test I had. I'm not a medical person, but I'm getting there!

[Mack184]

I am reluctant to post a specific name on a public forum. I simply advise that if it seems like too many tests are being run, if you are being told you need a nuclear stress test if in fact you are capable of doing a treadmill test, if the office seems to run like an assembly line, if you overhear one patient after another being scheduled for angiograms, if you get bills which do not reflect what was actually done, etc., steer clear.
Let me explain something. My wife is a very qualified medical professional. Most doctors today will put you through lots of tests. Many tests that you cannot understand why they are doing it and what it has to do with your case. It is not fraud. They are protecting THEMSELVES!!!

Unfortunately in today's world doctors are being sued at the drop of a hat. And when that case gets into court the doctor and the attending nurses and assistants are going to be grilled over and over and over again as to why this test or that test was not run. And then when the lawyer finds some little test that wasn't run because the doctor didn't feel you needed that test, he's going to be sued for millions of dollars!!

No..maybe you won't sue the doctor, but hundreds of others are going to try because they have been misled that they have been "injured" by neglect and that they can now hit the lottery off this doctor or provider's misfortune. Have you looked at any TV (not the villages) commercials these days? There are lawyers by the boat-load offering to "get you substantial money" from some doctor who didn't perform some test, which had nothing to do with providing you with good healthcare.

Most extra tests have nothing to do with fraud. It's about your doctor keeping his license to be able to save your life!!!

[shrink]

Let me explain something. My wife is a very qualified medical professional. Most doctors today will put you through lots of tests. Many tests that you cannot understand why they are doing it and what it has to do with your case. It is not fraud. They are protecting THEMSELVES!!!

Unfortunately in today's world doctors are being sued at the drop of a hat. And when that case gets into court the doctor and the attending nurses and assistants are going to be grilled over and over and over again as to why this test or that test was not run. And then when the lawyer finds some little test that wasn't run because the doctor didn't feel you needed that test, he's going to be sued for millions of dollars!!

No..maybe you won't sue the doctor, but hundreds of others are going to try because they have been misled that they have been "injured" by neglect and that they can now hit the lottery off this doctor or provider's misfortune. Have you looked at any TV (not the villages) commercials these days? There are lawyers by the boat-load offering to "get you substantial money" from some doctor who didn't perform some test, which had nothing to do with providing you with good healthcare.

Most extra tests have nothing to do with fraud. It's about your doctor keeping his license to be able to save your life!!!

That's an interesting perspective, and I'll think that over. Thanks for sharing.

[Villages PL]

Let me explain something. My wife is a very qualified medical professional. Most doctors today will put you through lots of tests. Many tests that you cannot understand why they are doing it and what it has to do with your case. It is not fraud. They are protecting THEMSELVES!!!

Unfortunately in today's world doctors are being sued at the drop of a hat. And when that case gets into court the doctor and the attending nurses and assistants are going to be grilled over and over and over again as to why this test or that test was not run. And then when the lawyer finds some little test that wasn't run because the doctor didn't feel you needed that test, he's going to be sued for millions of dollars!!

No..maybe you won't sue the doctor, but hundreds of others are going to try because they have been misled that they have been "injured" by neglect and that they can now hit the lottery off this doctor or provider's misfortune. Have you looked at any TV (not the villages) commercials these days? There are lawyers by the boat-load offering to "get you substantial money" from some doctor who didn't perform some test, which had nothing to do with providing you with good healthcare.

Most extra tests have nothing to do with fraud. It's about your doctor keeping his license to be able to save your life!!!

All the more reason for us to educate ourselves so we can refuse these unnecessary tests. Many years ago I did refuse an expensive moving picture xray of my neck. I had some difficulty swallowing which was due to heat stress. It was gradually getting better (it's a long story) but the doctor recommended this test to rule out cancer. I reasoned that if it was cancer, it would have gotten worse over time, not better. So I refused the test.

[rubicon]

Let me explain something. My wife is a very qualified medical professional. Most doctors today will put you through lots of tests. Many tests that you cannot understand why they are doing it and what it has to do with your case. It is not fraud. They are protecting THEMSELVES!!!

Unfortunately in today's world doctors are being sued at the drop of a hat. And when that case gets into court the doctor and the attending nurses and assistants are going to be grilled over and over and over again as to why this test or that test was not run. And then when the lawyer finds some little test that wasn't run because the doctor didn't feel you needed that test, he's going to be sued for millions of dollars!!

No..maybe you won't sue the doctor, but hundreds of others are going to try because they have been misled that they have been "injured" by neglect and that they can now hit the lottery off this doctor or provider's misfortune. Have you looked at any TV (not the villages) commercials these days? There are lawyers by the boat-load offering to "get you substantial money" from some doctor who didn't perform some test, which had nothing to do with providing you with good healthcare.

Most extra tests have nothing to do with fraud. It's about your doctor keeping his license to be able to save your life!!!

Mack: You are spot on. Yet, you have the government and insurance companies making decisions on what test, operations a doctor can conduct. Does that make sense? Neither the governemnt or an insurance comapny should get between you and your doctor. if the government or an insurance comapny believes that their are abuses then they have the tools to investigate.

Finally "he who doctors himself has a fool for a patient

[wendyquat]

Shrink, I sent you a pm.

[Villages PL]

Let me explain something. My wife is a very qualified medical professional. Most doctors today will put you through lots of tests. Many tests that you cannot understand why they are doing it and what it has to do with your case. It is not fraud. They are protecting THEMSELVES!!!

The owner/manager of the new Villages Clinics has promised to save money by not doing ANY unnecessary testing. And this is supposed to be the result of employing better doctors.

How does this square with your suggestion that doctors need to give lots of tests to protect themselves?

[Villages PL]

Finally "he who doctors himself has a fool for a patient

Those who can't think for themselves should at least go for a second opinion.

[OurHappyHome]

The problem you are all missing is the meaning of the word necessary. We do our best to diagnose and treat patients. Obviously, this is how we make a living. But, I found that you do make more money by being the best doctor possible and treating your patients the same way you would treat another physician, i.e. an educated consumer.

That being said, this is not making a cake where there is an exact recipe. For example, my neighbor just went to the hospital with symptoms and a history that would force a good doctor to do a heart work up. That would include labs (done many times over 3 days) and a stress test. All this to rule out something he didn't have.

In some hospitals he also would have had to do an angiogram. This is an invasive procedure, and that may have been the time for the patient to ask himself if it is 'really' needed. The question are: do you do the test to be sure or safe? In addition, do you do it to protect against malpractice if something is there that could be missed?

This is an art and a science, and as doctors... we make EDUCATED guesses. I am not speaking to what this doctor ( the one in the thread ) did or should have done. I can just tell you that most doctors don't spend 10 plus years or 75 plus hour weeks with little or no pay, motivated by ripping people off.

Mostly they want to help people. I know there are a few bad apples. But maybe this thread could have started with: 'Do you think these tests A,B, and C are excessive for these symptoms?' 'What tests have your doctor done for this?'... That might have opened a more useful dialog.

P.S. Sorry for any typos as I did this on my iPhone.

[pooh]

The problem you are all missing is the meaning of the word necessary. We do our best to diagnose and treat patients. Obviously, this is how we make a living. But, I found that you do make more money by being the best doctor possible and treating your patients the same way you would treat another physician, i.e. an educated consumer.

That being said, this is not making a cake where there is an exact recipe. For example, my neighbor just went to the hospital with symptoms and a history that would force a good doctor to do a heart work up. That would include labs (done many times over 3 days) and a stress test. All this to rule out something he didn't have.

In some hospitals he also would have had to do an angiogram. This is an invasive procedure, and that may have been the time for the patient to ask himself if it is 'really' needed. The question are: do you do the test to be sure or safe? In addition, do you do it to protect against malpractice if something is there that could be missed?

This is an art and a science, and as doctors... we make EDUCATED guesses. I am not speaking to what this doctor ( the one in the thread ) did or should have done. I can just tell you that most doctors don't spend 10 plus years or 75 plus hour weeks with little or no pay, motivated by ripping people off.

Mostly they want to help people. I know there are a few bad apples. But maybe this thread could have started with: 'Do you think these tests A,B, and C are excessive for these symptoms?' 'What tests have your doctor done for this?'... That might have opened a more useful dialog.

P.S. Sorry for any typos as I did this on my iPhone.

Thank you!!!

(And you did a fine job using your phone.)

[Mack184]

The owner/manager of the new Villages Clinics has promised to save money by not doing ANY unnecessary testing. And this is supposed to be the result of employing better doctors.

How does this square with your suggestion that doctors need to give lots of tests to protect themselves?
What do you mean how does it square? What is his definition of unnecessary? What is his definition of better doctors? Did they come from better medical schools? Did they have excellent patient records? Does he pay them more? My wife has walked in to see a patient and the patient, or someone with them flips open a notebook and starts writing things down. When my wife askes what they are writing she has been known to get answers such as "This is just in case we decide to sue you later". Again, define unnecessary.

[ssmith]

Agree with your post and the the good doctors post. Unfortunatley dueto the legal system and the law suits, doctors have to order tests. I am an RN in a large Cardiology office up north.

Know this, you also have the right to refuse a test. I am glad that nothing was wrong with you but most Americans do have build up in their arteries due to our lifestyle and diet and with other factors like smoking, family history, etc it is warranted to check it out.

I would call the billing dept. at the office so they would explain the billing that was done.

[Villages PL]

There are lawyers by the boat-load offering to "get you substantial money" from some doctor who didn't perform some test, which had nothing to do with providing you with good healthcare.

Again, define unnecessary.


I think you defined unnecessary tests above. In your own words, "....some test[s], which had nothing to do with providing you with good healthcare."

[PaPaLarry]

All heart patients should be warry of all heart doctors, in my opinion. Most of them (again my opinion) will never give the option of lifestyle changes to reverse coronary artery disease. They are in business to make money and placing stints or giving by pass surgery pays a heck of a lot more than giving someone a stern warning and a diet/exercise plan.
I don't agree with that. I go to Florida Heart & Vascular and really appreciate the way my Heart Doctor cares. In fact, I like going through tests that Doctor recommends, when its needed, to determine questions that arise. Because of Doctor and tests, I now see Heart Doctor once a year. Having a good heart mentally, helps a heart physically. God Bless our medical Profession. Bad apples are everywhere, but doesn't mean the tree is bad

[Mack184]

I think you defined unnecessary tests above. In your own words, "....some test[s], which had nothing to do with providing you with good healthcare."
You don't get it..and you never will. I'm out.

[Villages PL]

I don't agree with that. I go to Florida Heart & Vascular and really appreciate the way my Heart Doctor cares. In fact, I like going through tests that Doctor recommends, when its needed, to determine questions that arise. Because of Doctor and tests, I now see Heart Doctor once a year. Having a good heart mentally, helps a heart physically. God Bless our medical Profession. Bad apples are everywhere, but doesn't mean the tree is bad

From my experience on this board and elsewhere, most people will say that we (patients) don't know enough to make our own decisions. They say we are fools if we try to make our own decisions. But, often, those same people claim to know the difference between a "good" doctor and a "bad" doctor. On what basis do they decide if they don't know which tests and treatments are needed and which are not needed?


I think perhaps most of it is decided because of the atmosphere that is created in the doctor's office. If a patient gets a warm attentive reception from the receptionist, nurse and doctor, that tends to put one in a happy receptive mood. From there on in, much of what is done is judged to be necessary. And that judgement comes inspite of the fact that we are told that we are not supposed to know anything. In most cases, I would call such judgements "nebulous".

There's a saying that goes something like this: Caring about the patient is one of the most important tools in a doctor's practice, so, if the doctor can fake it, he or she has it made.

Note: Bernard Madoff was a smooth operator who seemed to care about people, or so they thought, until he was found out to be a crook who only cared about himself.

[2-crazy]

I for one understand the frustration that ‘shrink’ is going through and the DoctorA comment about the malpractice suits is right on target. In my opinion many tests performed is to protect against those suits that are common in this medical field. It is the current medical system and insurance firms that drive this sometimes unnecessary function in a doctors practice. There is a reason it is called a practice and with the specialty in medicine, the GP cannot take the chance of diagnosing anymore even if they think they know the problem. Sad state of affairs.

[Shirleevee]

Thank you!!!

(And you did a fine job using your phone.)

When we moved here, my husband went to a Cardiologist and told him of all his health issues. After taking a verbal history and noting that he is extremely active and eats clean, he said that he would like to do a stress test. That done, he said he wanted to do an Angiogram. Hubby had one the previous year and all was well.......but he had one and a 90% blockage was found. I thank that doctor every day for what some would consider unnecessary tests.

[Villages PL]

When we moved here, my husband went to a Cardiologist and told him of all his health issues. After taking a verbal history and noting that he is extremely active and eats clean, he said that he would like to do a stress test. That done, he said he wanted to do an Angiogram. Hubby had one the previous year and all was well.......but he had one and a 90% blockage was found. I thank that doctor every day for what some would consider unnecessary tests.

I see that in a previous post you indicated that heart disease was already well established. Therefore, that's not an example of something I would call, "unnecessary testing". I never said not to test patients who already have established heart disease.

[thealex]

I think that you have done the responsible thing in alerting readers about alleged fraudulent medical practice. I also think that Florida has some of the highest medical costs and the lowest health outcomes in the country. You really should identify this practice if for no other reason than to verify the truth of your post. I think it equally important that patients take responsibility for their own health and not just roll over for the doctor, especially once you've been alerted.

[Shirleevee]

I see that in a previous post you indicated that heart disease was already well established. Therefore, that's not an example of something I would call, "unnecessary testing". I never said not to test patients who already have established heart disease.

Yes, but he had tests a few months before in NY and all was well then. Wouldn't that lead some into thinking that all was STILL well? I would rather have a doctor covering his own behind than not!!!

[Villages PL]

Yes, but he had tests a few months before in NY and all was well then. Wouldn't that lead some into thinking that all was STILL well? I would rather have a doctor covering his own behind than not!!!

Based on your thinking, the American Heart Association should now recommend that (all?) heart patients get retested every few months. But if the retesting comes under the heading of a "second opinion" it may be justified. Could it be that the doctor retested because he knew he should be warry of cardiologists, some of whom are not trustworthy? If so, he made my point.

[Garden guru]

All of this just serves to confirm my suspicions: Too many profit-seeking doctors in The Villages with poor academic credentials, trying to exploit an older population. I'm a retired registered nurse who recently moved here. The pathetic state of health care in The Villages scares me. I finally decided my health is worth driving an hour up the road to the University of Florida in Gainesville. I don't trust this place; I've found a doctor there.

[kagney123]

Just wanted to add a little something my dearest dad may he rest in peace always said...
What do you call the guy who graduated last in his class in medical school???

[OnTrack]

What do you call the guy who graduated last in his class in medical school???

A heartless cardiologist? :D

.

[dillywho]

Say what you want, but I still have my husband thanks to the doctors and the hospital right here in TV. They have saved his life twice now. He would now be dead if he had tried to go to Leesburg, Gainesville, or anywhere else. He would have died long before getting there.

Personally, I like and will take my chances here. Sure seems to pay off for us. Some of the very best cardiologists are here. Probably some of the worst, too. The same can be said for all the primaries/specialists anywhere.

And, as someone else pointed out, nuclear stress tests are done on the treadmill. The nuclear medicine gives a much clearer picture (literally) of how the heart is functioning before and after stress.

[cindy117]

Almost exactly the same thing happened to us. I know the practice you are talking about. It is not just one cardiologist in this practice who engages in this approach. Note that these tests are not risk free - our cardiologist up north told us to beware of ending up on the operating table for no good reason after these unnecessary tests.

[NotGolfer]

Say what you want, but I still have my husband thanks to the doctors and the hospital right here in TV. They have saved his life twice now. He would now be dead if he had tried to go to Leesburg, Gainesville, or anywhere else. He would have died long before getting there.

Personally, I like and will take my chances here. Sure seems to pay off for us. Some of the very best cardiologists are here. Probably some of the worst, too. The same can be said for all the primaries/specialists anywhere.

And, as someone else pointed out, nuclear stress tests are done on the treadmill. The nuclear medicine gives a much clearer picture (literally) of how the heart is functioning before and after stress.

AMEN!! Couldn't agree with you more regarding T.V. health-care system vs. somewhere else.

Folks talk to other folks and gather opinions, many times, by someone else's experience. I think it's prudent to do your home-work (if it's possible) via the internet etc. to find out the credentials etc on any health-care provider. Certainly someone can graduate from the best school and have good credentials and still not bear up to being a good doctor! Sometimes it's perception on the patient's part as well. There are great doctors here and some who aren't...just like other areas of the country!

[beekman]

Post the doctor name on a small piece of paper this Friday on the backside of the radio station at the Landing after dark. Do it quickly and don't leave your name on it. Interested readers can then proceed there to see it only after 8 pm to protect the poster. :) James Bond 007 stuff!!!!!!

[2BNTV]

I am writing this post to warn others of fraud and abuse which apparently is rampant in Florida. Medicare has established a separate fraud department specifically to investigate Florida claims! Specifically, I saw a cardiologist after my husband was referred to one. It was recommended to me by that cardiologist that I have an initial workup because of my family history and a past hx of smoking. I was asymptomatic, but told that heart disease presents differently in women. Better safe than sorry, right? I was immediately referred for a nuclear stress test (never offered the option of a cardio treadmill stress test). That test cost in excess of $2400., whereas the treadmill test would have been $174.00. Hmmm...never mind, as Medicare and my private insurance were also charged for the treadmill test (which I never had). As a result of the "equivocal" findings on the stress test, it was recommended that I start on Digoxin and also have an invasive angiogram (thousands more) to see what's going on. In the meantime, I was given several other tests, including sonograms, leg studies, etc. which I have since discovered EVERYONE who sees this doctor is given. I decided to seek a second opinion from a reputable cardiologist out of state. That doctor (and I) requested records be sent a total of FIVE times. No records were sent until I called the cardiologist down here and threatened legal action. I now understand why those records weren't sent as requested. It was because there is NOTHING WRONG with my heart, as per my second opinion! By the way, my husband was given all the same tests AND underwent the angiogram...and there was nothing wrong with him, either). My reason for writing this post is to make all Villagers aware of what can go on here. Be sure to carefully check all of your medicare/private insurance statements to see what you've been billed for. Do NOT engage in a ton of tests without getting a second opinion for someone highly reputable. Just because you may not have to pay for those tests directly, we all pay indirectly. Although I'm sure that some of the physicians here are honest, are not referring to establishments where they have financial interests for unnecessary tests or to specialists with whom there is some kind of reciprocity, many are. PLEASE EXERCISE CAUTION.

I noticed this thread is over a year old.

My PCP saw something, that he said nmight be something, or nothing. He referred me to Dr. Miryala. Dr. Miryala recommended a nuclear stress test with the accompanied pictures. I found him to be very thorough and competent. He put me on a low dosage aspirin, (81MG), and I see him in January, 2014. So far, so good. :smiley:

I highly recommend Dr. Miryala for anyone, who is having heart problems.

[Shimpy]

I noticed this thread is over a year old.

My PCP saw something, that he said nmight be something, or nothing. He referred me to Dr. Miryala. Dr. Miryala recommended a nuclear stress test with the accompanied pictures. I found him to be very thorough and competent. He put me on a low dosage aspirin, (81MG), and I see him in January, 2014. So far, so good. :smiley:

I highly recommend Dr. Miryala for anyone, who is having heart problems.

My wife goes to Dr Miryala and I was so impressed with him I am changing myself to him for a cardiologist in the near future.

[dillywho]

I'm glad to know that you were satisfied with the treatment you received and the outcome was good. As for a lawsuit, I've been involved in two of them (neither medically connected) and came out of them never wanting to be involved in one again although I did 'win' in both cases. The truth of the matter is that the attorneys won as they do in most suits. Life is too short to waste it on things that really do not matter.

I maintain that my advice to get out of The Villages is valid. Even if you have a great physician, the requisite support does not exist here. Ask yourself the question, "If my physician is as good as I believe, why isn't he/she practicing in a major medical center?"

This may come as a shock to you, but all doctors in a major medical center are not the best. As for being in it for the money, you will find more of that in your "major" centers. The one exception that I know of for that is Mayo. All the doctors at Mayo are salaried. My ear doctor here in 2007 referred me to Mayo in Jacksonville for surgery. That when I found out how Mayo is operated. They do not accept Medicare, but will file it for you. Medicare will pay you, file your secondary, and then you pay the full charges at Mayo. Yes, I had excellent care at Mayo and continued support here.

As far as the cardiac support here, ours could not be better. Our first cardiologist experience was not good, as I described in another post. We no longer have him. The one we have now is superior. He does not do the interventions, but does the routine care and it DOES include lifestyle, diet, etc.

The doctors who have done the interventions have been the best as far as we are concerned. Because of both of them, my husband lived and is still living to this day. Because of the follow-up, he was able to recover to the point where it was not necessary to implant a defibrillator.

Do some have bad experiences here? Yes. Does that mean that every doctor that practices medicine here is bad? Absolutely, not. These doctors are doctors....not God. God has not gone on vacation and left anyone else in charge to my knowledge.

Sorry, if I sound caustic, but to bad-mouth an entire medical community or any other (restaurant, etc.) community, is just wrong to me and really gets my dander up.:cus:

Off to cheer up now. Merry Christmas and Happy New Year to all!:gc:

[gerryann]

Just opened this thread up. This is the most ridiculous thread ever posted here.....was the dr ever named? Good grief...thanks for the warning...I'll be sure to not make an appointment with Dr ??????????????????

[billethkid]

has a faint hint of bait....maybe not....but mode sure smells like it.

btk

[Jsling]

That's not fair to all of us.
You can post the name. You are essentially telling everyone to go into an office and if it smells like what you described, steer clear. That's not fair bc all offices are busy and can almost be what you described but still be a good office with very good doctors. If you are going to post something like this, you should provide a name.

[mulligan]

Easy, folks. NEVER go to a cardiologist in TV. Problem solved.

[jimmy D]

Without the name this is just a rant maybe a dream or maybe a false story. Why not a name. do you think they look at this stuff. Your heart rate must be high and getting higher. Not fair to the Good ones

[Bogie Shooter]

don't get all upset................the OP was 9/2012. Patient and doctor are probably both gone.

[OurHappyHome]

Lots of information but I didn't find anywhere to "click on" to find out their diet recommendations for reversing coronary artery disease. So that leaves me skeptical. In my mind it means the clinic doesn't want to do anything that substantive which could potentially take business away from doctors.

He has several books on reversing heart disease

[gerryh1943]

Can we have a name

[Neal2tire]

We name food establishments and bartenders names. Very negative and honest every day. Without naming this 'business' (that is what a Dr is) you perhaps are causing a panic. How do I know this? Because my wife is a bit nutty wondering who this potential criminal is. Medicare fraud is a federal crime. I by the way, just had a heart attack at the age of 56 and new to TV (2 years) A very touchy decision had to be made by my cardiologist during the surgery.
A life and death decision was made by all as we followed his lead. Irreversible by the way. Now with this posting we can only lie back tonight and wonder if this was the doctor in "in The Villages".
I for one trust my cardiologist but imagine how many people are heading off to see their dr. this week with this in the back of their mind.
I would suggest naming the medical group in general or be a bit more cautious in the future about raising an alarm.
Merry Christmas and New Year
NG

[Moderator]

This thread is over a year old. It contains some useful general information about dealing with medical offices but since the OP decided not to name the specific office, it generated a lot of skeptical and anxious comments.

Topic has been thoroughly discussed and will now be closed.

Feel free to start a new thread with new or more current information.