Imagine that you are a high-risk patient suffering from heart failure or cardiac arrest. Imagine that you live in a big city and are immediately taken to a nationally renowned teaching hospital nearby. Such hospitals are seen as leading the way in research and treatment capabilities.
But it happens to be the week of one of the two major cardiology conventions held in the United States each year. A large percentage of the country’s cardiologists – including yours – are at that meeting.
Are you more likely to die as a result? Most people would assume so. But a study led by a Harvard researcher, involving tens of thousands of patients mostly age 65 and up around the country over a ten-year period, concluded that the facts are the opposite of what you might expect.
At teaching hospitals, it turns out that asmaller percentage of high-risk patients suffering from heart failure and cardiac arrest died in the 30 days following admission when they were hospitalized during national cardiology conventions. Said another way, a higher percentage died when more cardiologists were available to treat them.
Heart failure patients had a 17.5 percent chance of dying within 30 days when admitted during the weeks of those conventions – but a 24.8 percent chance of dying when admitted at other times. Cardiac arrest patients had a 59.1 percent chance of dying within 30 days when they entered the hospital during those events that took many cardiologists away – but their chances of dying were ten percentage points higher, 69.4 percent, when they were admitted at other times.
How can it possibly be true that fewer people died when a large percentage of the relevant doctors weren’t available to treat them?
This study echoes a refrain that researchers have been repeating for decades: “more care” does not automatically mean “better care.” The latest and greatest technology does not necessarily get better results than simpler, less snazzy approaches that have been available for years.
The authors of the study speculate that more attention from cardiologists means more aggressive care; patients get more treatments, including invasive procedures such as implanting stents. While stents can save lives when used appropriately, this treatment -- like many others – is often used in situations where it is unlikely to help.
Overuse of treatments occurs in all branches of medicine, not just cardiology.
What can you do? Ask questions, such as: how is success defined for this treatment? What percentage of patients like me – in terms of age, gender, severity of illness, other health problems, etc. – get that successful result? Often, care that is lifesaving for some people isn’t just wasted when given to people whose circumstances are different – it can harm or even kill them.