Cardiologist = Moneyologists

I was at a conference last week and I overheard some a group of cardiologists talking. One of them mentioned that Medicare is now going to pay less per echocardiogram than they paid before and that they are trying to cut payments in half.

They chuckled and said they'd just order twice as many echos, read them in half the time, and do a crappier job of reading them. How bizarre is that?

I think Cardiologists are out to make money at all costs.

Example, I was covering a friend of mine last weekend. He ordered a cardiology consult on a gorked out gomer from a nursing home with no brain function and a peg and trach and minimal functionality. He wanted them to offer an opinion on her rising troponins.

What did the cardiologist do? Before even seeing the patient, he ordered an echo, carotid dopplers, bilateral lower and upper extremity dopplers, and a stress test. WOW! and WOW!

This isn't the first time. I've stopped using cardiologists and specialists that order a million tests. I hate sending a patient to a specialist and they come back after $4 million dollars worth of testing with "nothing."

I could have told you that.

I think the best specialists are the ones that know what's going on without ordering billions and billions of dollars worth of tests.

A very smart endocrinologist told me once, "you can tell how smart a doctor is by seeing how many tests they order. The more tests they order the dumber they are."

I firmly believe this.

A dear friend of mine who is a damn good cardiologist warned me about the guys who just order tons of tests no matter what. He says that they need to be more discriminatory and reasonable. You DO NOT NEED AN ANNUAL ECHO! YOU DO NOT NEED AN ANNUAL STRESS! YOU DO NOT NEED AN ANNUAL CAROTID DOPPLER!

If your specialists start doing this.... time to find a new one.