An internal investigation prompted by a letter from a former nurse at HCA — the largest for-profit hospital chain in the United States with 163 facilities — revealed that unnecessary testing may have been the norm in the hospital’s cardiology department.
The finding might indicate a disturbing trend in hospitals in Oregon and across the country. According to a recent anonymous survey, orthopedic surgeons indicated that 24 percent of the tests they ordered may not have been medically unnecessary. In addition, doctor visits resulting in prescriptions of 5 or more drugs have nearly tripled since 1996. The number of MRI scans in the same period quadrupled.
There might be several reasons for the unnecessary testing. In an effort to prevent misdiagnoses and errors, doctors might be overcompensating. Perhaps extraneous tests are ordered to drive up costs and increase profits.
However, such tests might actually be dangerous. For example, extra procedures might require subjecting patients to additional — and unnecessary — medical risks. Similarly, the extra procedures might expose patients to infection, allergic reaction or additional complications.
In a conference call earlier this week with investors, HCA company executives disclosed that attorneys from the local United States attorney’s office had requested information on reviews assessing the medical necessity of interventional cardiology services provided at 10 of its hospitals.
In addition to legal liability, HCA could also be facing financial repercussions for any unnecessary testing. For example, it might be required to reimburse Medicare, state Medicaid or private insurers for any procedures later deemed unnecessary.
Source: The New York Times, “Hospital Chain Inquiry Cited Unnecessary Cardiac Work,” Reed Abelson and Julie Creswell, Aug. 6, 2012
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