We all should be careful and judicious in selecting the procedures protecting the safety of patients

http://mobile.nytimes.com/2015/01/30/business/medicare-payments-surge-for-stents-to-unblock-blood-vessels-in-limbs.html

Medicare Payments Surge for Stents to Unblock Blood Vessels in Limbs

JANUARY 29, 2015Earlier this month, the Justice Department said it joined two whistle-blower lawsuits accusing one of these doctors of performing unnecessary procedures, including placing a stent in the leg of a patient who later died of complications. A Shift in Procedures

By JULIE CRESWELL and REED ABELSON

At a time of increasing scrutiny of procedures to open blocked heart arteries, cardiologists are turning to — and reaping huge payments from -- controversial techniques that relieve blockages in the arms and legs.

Unlike heart procedures, which must be done in a hospital or outpatient facility, where oversight is typically more intense, the opening of the peripheral arteries and veins of the arms and legs can be done in a doctor’s office.

Medical experts are questioning the necessity of some of these treatments, and many believe the condition is more safely treated with drugs and exercise. Nonetheless, some of the nation’s most highly reimbursed cardiologists are making millions of dollars from Medicare for performing these procedures, as payments for relieving blockages in the heart have fallen.

Among Medicare patients, operations to improve blood flow in the heart (including balloon angioplasties and stents, but excluding coronary bypass surgery) have fallen by 30 percent since 2005. But in the peripheral vessels, mainly in the leg, similar operations have increased by 66 percent.