It’s A Slippery Slope Being a Doctor

This piece written by trial lawyers, of all things, in the WSJ was eye-opening for me. We all know that in EVERY profession there are bad apples. Look at the opioid crisis, for example, and the “pill mill” docs. I want every one of these idiots prosecuted. The problem is, however, that it’s not that simple. Look at this case in the article:

Dr. Paulus was indicted by federal prosecutors, accused of putting stents into the coronary arteries of people the government said didn’t need them.

Concerned about the quantity of coronary-stent procedures performed at King’s Daughters, federal prosecutors hired a pair of doctors to review Dr. Paulus’s old cases. In some patients, Dr. Paulus had reported arterial blockages of 60% while the government’s doctors said that the patients’ angiograms—essentially chest X-rays—showed blockage of 30% or less. The government took this as proof that Dr. Paulus had misdiagnosed patients as part of a scheme to defraud Medicare, Medicaid or private insurance companies.

Here is the deal. Richard Paulus MD is a very highly regarded doctor. During the trial, experts could NOT even agree on how much different arteries were blocked on angiograms. It says a lot about our ability to pick up and treat CAD, huh? Anyway, the jury convicts Paulus but the judge overruled the verdict and granted an acquittal. The story didn’t end there:

Citing the Sixth Circuit’s ruling in a recent case that variability in cardiology is limited to 10%, the panel overruled Judge Bunning and reinstated Dr. Paulus’s conviction. 

This is scary stuff. Dr. Paulus is 71 and will be sentenced in March. A Ohio-based cardiologist Harold Persaud, who was convicted in 2015 of similar charges, is serving a 20-year prison term!

So, to be fair, this article was written by his attorneys and it is biased. I really do want doctors, who exploit patients for financial gain, to be punished. But it can be a really slippery slope. Dr. Paulus is going to jail. Is he a bad guy? I don’t know but King’s Daughters Medical Center in Ashland, Ky even put his name on the front of its heart center.

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