. The research shows that Pat Sharma wanted to let Copyright 2021. degeneration, Women's Under the Affordable Care Act doctors who create a medical home also will be rewarded if they are able to keep their patients healthy and out of the hospital, while avoiding invasive treatments. Maggie, Samin Sharma is a Nephrologist in Kalamazoo, MI. Sinais King of Stents, ran a cath lab which was central to this campaign, performing procedures that typically brought in as much as $20,000 a As Americans we tend to believe in whats newas if medical science progressed in a straight linear fashion, one breakthrough after another, from Madame Curie to me. . During the previous six months, Sinai had lost $50 million, partly as the result of tougher caps on Medicare reimbursement rates. 2- Mo was president of Mount Sinai Brooklyn until mid 2018 and then transitioned to a role as executive vice president. 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. First, my own experience goes like this. He accepts multiple insurance plans. No doubt many of the New Jersey insurers customersand some physiciansobject to the requirement. WebMount Sinai's Dr. Samin Sharma discusses the treatments available for heart disease. 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 Patients may wish to ask their physician about the activities they perform for companies. sclerosis, Parkinson's Clinical Manby Clifton Meador (Why Do So Many Of Us Need Medical Tests to Tell Us That We Are Well? In addition, the Medicare Payment Advisory Commission (MedPAC) has suggested that when Medicare spots high volume combined with high profits margins, this is a place to look for overtreatment. The content on this website is intended to be used for informational purposes only. Finally, if there is a finding that a doctor willfully or fraudulantly billed for false charges to Medicare, Medicaid, or private insurance, the doctor would be liable for a judgement of insurance or Medicare fraud. doctor, Find No one can ever tell me that I didnt need that stent, she told the Baltimore Sun. . If hospital compliance departments want to perform their own audits as well, more power to them. I had quintuple bypass surgery in 1999. 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. The problem is that some, probably many or most, cardiologists believe that once they discover what they consider to be a significant stenosis they more or less HAVE to treat it to prevent it from causing the patient problems down the road. 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. Medicare wants to put hospitals under some fianncial pressure because MedPAC reserach shows that when hospitals are under financial pressure, they learn to become more efficientand, in fact, beginning making a profit on those Medicare reimbursements. Reproduction, forwarding or reuse in any form is prohibited. whilst Im enthusiastic about CMS moving toward capitation, Im not holding my breath. Conversely, I also wonder how many patients who receive stents would have been better off for the longer term with a CABG. I think its encouraging that doctors may be starting to perceive greater litigation risk from doing this procedure as opposed to not doing it. Government (taxpayers) already pays more than 50% of all health care bills in the U.S. But some do set out to over-charge insurers, Medicare or Medicaid, and sometimes the patient suffers the collateral damage. A shocking number of them fall into the categories of Dangerous or Questionable.. To arrange an appointment, call the number on Dr. Sharma's profile. This edition of Pulse Extra highlights the highest-paid people working for hospitals and health systems in 2019. per day. 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. But in your last paragraph I think you mean but the studies are NOT very effective ??? There will be incentives to join Accountable Care Organizations where doctors or doctors and hospitals work together, and all share in the financial rewards if they are able to avoid waste. In 2007 Business Week told the story of how stents rescued New Yorks Mt. 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. This is true. (Oh yeah, except for the ones regarding professionalism. . What Cant Happen, Wont. Major emphasis of the live course has been the technical aspects of safely performing complex coronary interventions. executive vice president, finance, and chief, corporate services, executive vice president and president of Mount Sinai Health Network, executive vice president and general counsel, executive vice president and chief integration officer, executive vice president and chief executive, Mount Sinai Doctors Faculty Practice, executive vice president and chief administrative officer, executive vice president and chief population health officer, senior vice president and system chief medical officer, senior vice president and chief financial officer, senior vice president and system chief risk officer, senior vice president and executive director, Mount Sinai Hospital Queens, president; executive vice president and chief clinical officer, Mount Sinai Health System, senior vice president and chief operating officer, senior vice president, real estate and facilities, vice president and chief, ambulatory care. Soon the lab was averaging 15 off-hours patients a month. Samin Sharma, Mt. (caps added to no for empnasis.). If the first and second doctor each worked for the hospital with their compensation tied, at least in part, to the hospitals revenue and profit, Im skeptical how many times the first interventional cardiologist would be overruled. (You will find the abstract here) Following a two-year study, researchers at the Cedars-Sinai Medical Center in Los Angeles are now suggesting that the putative superiority of drug-coated stents is founded on questionable premises. Or as The Wall Street Journal put it, the clinical trials of drug-coated stents (mostly funded by manufacturers), may have exaggerated their real-life advantage. [Dr. Midei was using a new generation of drug-coated stents.]. I understand that stent placement is a lucrative procedure for both the hospital and the interventional cardiologist. Instead, they skip from one specialist to another according to what body part gives them reason to complain that day, all the while gathering more and more bottles for the medicine cabinet. Phillip Longman Best Care Anywhere. This provider has 21 years of experience and is affiliated with Catholic As Maggie says, doctors who engage in inappropriate care are guilty of malpractice, a violation of contract (civil) law, not criminal law. 4- Schwab left at the end of 2020. 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. a 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. He left Mount Sinai in March 2021. 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. health. ] Oh, and by the way, it pays well too. Menu, Health I dont understand why and under what circumstances asymptomatic patients would ever be sent to the cath lab in the first place. Health Certainly, hospital executive knew that they were making handsome profits on Mideis stent procedures. thank you Dr Sharma. Dr. Samin Sharma, MD is a cardiology specialist in New York, NY. VA . As for whether hospitals can make money on Medicare-or lowered Medicare payments sse the Medicare Payment Advisory Commission report which I have referenced in the past showing that I am afraid that many hospitals have resisted the news for one simple reason: procedures that involve stents are extremely lucrative. health, Exercise He was then appointed as an attending at The Mount Sinai Hospital in 1990 where he is currently the Director of Interventional Cardiology (since 1996), Director of Clinical Cardiology (since 2011), Dean of International Clinical Affiliations (since 2011), President of Mount Sinai Heart Network (since 2011) and is the Anandi Lal Sharma Professor of Medicine, Cardiology. Your story is a good example of why anecdotal results dont mean much. Very sad stories. Yet drug-coated stents have become wildly popular, thanks in part to what The Annals of Internal Medicine describes as aggressive marketing and the unbridled expectations of patients. Being, Community Go to a non-hospital-based doctor in the community. Why has it taken so long for state medical boards to wake up? diabetes, Vaccinations and immunizations, Lung As you know, a profit margin turns on the cost of operations. COMPARISON OF THE MOUNT SINAI HOSPITAL INTERVENTIONAL OUTCOMES WITH NEW YORK STATE DATA: 20172021 Our Cardiac Catheterization Laboratory continues to serve the full range of cases, from the routine to the most complex 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. The Centers for Medicare and Medicaid is determined to move away from fee- for service payment because we know that inevitably, it leads to more procedures, yet earlier this year, the Commonwealth Fund reported that physicians and industry leaders [feel] that cost reductions of 20 percent to 30 percent are achievable under well-constructed global payment models which pay doctors a lump sum to keep patients well. Before turning to the new Cedars Sinai study, it should be said that THCB has long harbored doubts as to whether these cunning devices represented the best solution for quite so many patients. Its fast, but a band-aid fix. Because physicians insurance participation can change, the insurance information on this page may not always be up-to-date. For after reviewing outcomes research, Cedars Sinais clinicians found that the drug-coated stents increase the danger that a blood clot will form inside the stent months, or even years after the procedure. 3- Lorin was named President of Mount Sinai Brooklyn in May 2018. A well-trained internist can take care of the lions share of people with coronary heart disease. . policy, Press 4. 3. I have a different take on this. Sinais King of Stents, ran a cath lab which was central to this campaign, performing procedures that typically brought in as much as $20,000 a piece for the hospital. Under reform, accountability is likely to extend beyond the individual patient-doctor relationship. He got in touch with the blog to point out that he performs 1,500 complex coronary interventions each year, which apparently is an American record, Cardio Brief noted. Sharecare, About Hello, I got over to your post via Reddit. a doctor, Find He has authored over 350 articles, 420 abstracts, 15 book chapters and three books to his credit. arthritis, Diet Over the weekend, the New York Times published a head-turning tale about Dr. Mark Midei, a star cardiologist at St. Joseph Medical Center in Townson, Maryland. 1 Gustave L. Levy PlaceNew York, NY 10029-5674, 2023 Icahn School of Medicine at Mount Sinai Dr. Sharma completed a residency at Nyi Bd Hospital. These things may be true of manythough not necessarily most doctors. sciences, Sharecare+: A product of Crains New York Business. He also enjoys teaching other cardiologists through the annual live symposium called the Complex Coronary Cases (CCC) Symposium, which is in its 22nd year. The business address is 20 Castle Walk, Scarsdale, NY 10583-3221. Compensation included $126,600 in severance pay. To search within a table, use the box in the upper right corner. In the meantime, with modern data analytics, I think both public and private payers could more aggressively audit some of these cases to confirm medical necessity, especially when they notice unusually large numbers of procedures being performed by a given institution or a specific physician or group. policy, Health 3- Gandhi became chief financial officer of Mount Sinai Health System in March 2020. guide to managing depression, Understanding If you are using Internet Explorer, please consider upgrading to a modern browser. Dr. Samin Sharma, Mt. This provision is designed to put pressure on hospitals to become more efficient. 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. each other: anyone who has gone through this deserves to be a doctor. The Natl Practitioner Data Bank holds files on a whopping 1/4 million physicians just since 1985. Dr. Sharma provides telehealth services. A regular fixture on international, national, and local TV stations, newspapers and magazines, Dr. Sharma has been the focus of news stories for media outlets like: The Today Show, CBS News, NBC News, Fox News, PIX11, The New York Times, The Wall Street Journal, New York Magazine, Reuters, Businessweek, Cardiology Today, India Abroad, India Today, Barrons, Forbes, Newsweek, The Washington Post, CrainsNew York Business, NY Daily News, Newsday and New York Post. health, Skin Barry Dr. Sharma received his medical degree from S.M.S. run 75441- stent procedures offer relief from the pain of angina for a whilebut not forever. relations, Breast Meanwhile, Medicaid pays them less than 70% of their costs with more payment reductions coming due to state fiscal pressures. As Director of Interventional Cardiology, Dr. Sharma oversees all Health System catheterization laboratories to maintain the highest level of care. are more than atopic dermatitis, Understanding Pat At Lourdes, there were rumors for years that one of its surgeons, a Dr. Mehmood Patel, was performing vast amounts of unnecessary heart operations. degeneration, A Residency, Internal Medicine, New York University Downtown Hosp. The trend toward more hospital employed physicians makes it easier to consolidate vendors and standardize operating room protocols. And as Pat S. points out in his comment, pain-relieving drugs can help patients until the other medications kick in. Doctors Confirm Damar Hamlin Experienced Commotio CordisBut What Is It? We are being enormously group-stupid in not bringing the roof down on the bad boys of medicine. . According to the Sun: The 2007 study didnt find that stents are worthless, just that not implanting a stent can often be as good and avoids the real risks of complications or even death from the procedure. Hamburger Information regarding insurance participation and billing by this physician may be found on this page, and can also be obtained by contacting this provider directly. All, About Although St. Josephs has not admitted to any wrongdoing, last month it agreed to pay a $22 million fine to settle charges that it paid illegal kickbacks to Dr. Mideis medical practice in exchange for patient referrals. But doctors can go to jail for malpracticetypically if they are found guilty of fraud and malpractice. But this is an example of how insurers can add value to health care, not by trying to make treatment decisions themselves, but by calling for more collaboration. Both said that they could not make money if they had to take Medicare rates from all comers even if there were no uncompensated care. and treating thyroid eye disease, A A second 2005 study, published in The New England Journal of Medicine, added to the uncertainty about the widespread use of stents by reporting that patients suffering minor heart attacks do equally well with drug therapy. Yet it wasnt until one of Patels fellow doctors at last secretly sued him in federal court under a special whistleblower law that the hospital revoked his admitting privileges. Intent is very important. Office 1190 5th Ave New York, NY 10029 Book by Phone+1 (828) 373-6811 In my experience, these folks become as adept at reading cath films as any physician. cancer, Crohn's Since 2007 Study, Use of Stents Has Dropped, but Many Remain Undaunted, Not everyone has ignored the research. He is also great teacher . 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. Number of office visits you've had in the last 2 years: How would you like to confirm your survey information. 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. Dr. Some physicians remain clearly undeterred by the research. Still, there are ways stop them. 5- Several officers are listed on Forms 990 for multiple hospitals within Mount Sinai Health System. It makes perfect sense. Meanwhile, just last fall, Dr. Eric Topol, chairman of the cardiology department at the Cleveland Clinic, warned Consumer Reports: Unfortunately, the extensive use of such stents is far ahead of the data that can be cited to support them.. WebDr. Please contact this physician directly to obtain the most up-to-date insurance information. These hospitals need only two ORs. us, Community Dr. Sharma travels to India every month to teach the art of angioplasty to Indian cardiologists. Dr. Sharma 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. 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. Titles reflect positions held in 2019. According to federal investigators, Dr. Midei implanted potentially dangerous cardiac stents in the arteries of as many as 585 patients who didnt need them. Visit RateMDs for Dr. Samir Sharma Barry Greater transparency will make it much harder for those who manufacture stents to paint a rosy picture of risks versus benefitsthe FDA aims to make sure that these companies are not hiding information about risks. 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. Reproduction, forwarding or reuse in any form is prohibited. Interventional cardiology became a key revenue source for Sinai. Samin Sharma, M.D. equity, Investor 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. The popularity of stents is all part of a mindset that Drs. You can find other locations and directions on Sharecare, Likelihood of recommending Dr. Sharma to family and friends. disease, Mental blow the whistle on other doctors. Click on Contact Maggie on the blogs home page. As for hospital CEOs at overpaid hospitals in NYC and PIttsburgh who tell you they couldnt surive on Medicare paymtents? Koirala Institute of Health Sciences in Dharan, Nepal in 2002. 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 training you makes doctors extremely sensitive to criticism. In 1983, he came to New York to undergo residency in Internal Medicine at the NY Infirmary-Beekman Downtown Hospital (1983-1986), fellowship in Cardiology in Elmhurst Hospital (1986-1988), and interventional training at The Mount Sinai Hospital (1988-1990). 1- Officers' compensation was funded by Mount Sinai Hospital, Icahn School of Medicine, Mount Sinai Beth Israel, Mount Sinai West, and/or New York Eye and Ear Infirmary. 954 salaries reported, updated at April 25, 2023 These CEOs are making 7-figure salaries as a reward for running a hospital as a revenue center (as opposed to a patient-care center).Of course they will say that the government isnt paying hospitals enough. In July 2009, Dr. Sharma launched a monthly live web series, (www.ccclivecases.org), a revolutionary teaching tool in nterventional cardiology globally. He currently practices at The Lauder If it fails, then its your cost, not ours., Researchers virtually never take the bet because they know that most research fails, says Halvorson. arthritis, Type To search within a table, use the box in the upper right corner. . & consultants, Life My sense is that defensive medicine may be an important part of the equation that determines interventional cardiologists practice patterns in the U.S. even though its effect cannot be specifically determined or quantified. Despite the hoopla, nine months ago THCB was once again forced to ask Are Stents A Waste of Money? after reading about a study of 826 patients, published in Lancet, which suggested that the drug-coated stents made by J&J and Boston Scientific aren't cost-effective for all patients and should be restricted to those at highest risk for heart attack. Moon even enjoyed occasional use of the hopitals emergency helicopter to fly to golf tournaments. In addition, of course, doctors are subject to investigation and censure by their hospitals, potentially leading to loss of privileges (the right to work in the hospital) or other lesser sanctions, and by state medical boards, potentially leading to loss of license or other lesser sanctions. The stent story illustrates a major problem in our money-driven health care system. doing too much, they make mistakes. patients guide to Graves' disease, Understanding Though of course there are extreme cases where a doctor is consciously over-treating, but I suspect those are very rare. Thanks for the commentI am afraid you are entirely right. disease, Crohn's Dr. Sharma in specializes in Cardiology. equity, Investor Finallyand I am afraid this is a major reason a great many hospital CEOs protect their I was put on maximum medical therapy after the surgery and have been on it ever since. Capitation has remained more common the West, where HMO penetration remains greater. I would love to see the Times expand on these comments by exploring the larger national problem. Stents, you may remember, are those tiny metal scaffolds that cardiologists use to prop arteries open after they have been cleared of fatty deposits. Dr. Sharma is board certified in Cardiology and accepts accepts multiple insurance plans. Dr. Sharma's office is located at 1190 5th Ave New York, NY 10029. While looking at overtreatment, Dartmouth researchers realized that Redding was doing an extraordinary number of bypasses and angioplasties. Maggie If clearly unnecessary procedures are being done, especially when claiming that a blockage is much greater than the film shows it to be, the consequences for the doctor should be swift and severe including prosecution for fraud and, possibly, loss of his medical license. Dr. Sharma, his family, and other generous donors helped the Foundation reach its $5 million endowment, funding that will help support the labs clinical, research, and educational initiatives. Barry 2 diabetes, Women's Ordinarily, though doctors are not imprisoned for malprctice because society acknowledges that we all are human and even the very best doctors make mistakes. Please note: Interactive Pulse Extra is best viewed in a browser such as Google Chrome or Mozilla Firefox. And that 250,000 is considered an extremely low number, by those who understand the scope of the misbehavior. 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. Actually, I did say that asymptomatic patients undergo cath and stenting, under the circumstances that I outlined in my answer to Barry. Court findings of fraud or willful negligence also expose the doctor to potential punitive financial damages, in addition to the usual compensatory damages. Learn more about Dr. Sharma's background, education and insurance providers. MedPAC has found that the cost of operations at a great many hospitals is much, much higher than it needs to be. relations, Contact Ive read that the hazing experience of med school causes doctors to bond with WebDr. I take a beta blocker, an ACE inhibitor, a statin, an anti-spasmodic drug and a blood thinner plus baby aspirin. The Affordable Care ACt also cuts increases in payment to hospitals and nursing homes by 1% a yearevery year. * Please verify this information when scheduling an appointment. That hazingwhich includes being humiliated by people who are supposed to be Under the Affordable Care Act (ACA) bonuses will encourage doctors to move away from fee-for-service, and toward working on salary (as doctors already do at multi-specialty clinics such as Kaiser or the Mayo Clinic) or accepting capitated payments.
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