MEDICINE Angioplasty is common, lucrative

Researchers hope to enroll about 40 small hospitals from around the country.
TOLEDO BLADE
Angioplasty is among the most common -- and lucrative -- medical procedures done in big city hospitals, but a nationwide study could make them a lot more common in small community or rural hospitals.
That possibility has divided cardiologists. Many feel the technology for angioplasty -- a procedure in which a doctor reopens a clogged heart artery by inflating a tiny balloon in the artery -- has improved so much that there's little risk involved. It makes sense to allow patients to get the procedure done close to their home instead of driving to a large hospital, they argue.
"The odds of having people needing emergency surgery, even in a large institution, are very low," said Dr. Philip Dorfman, president of the Ohio chapter of the American College of Cardiology. "If [the study] determines it to be safe and effective so patients don't need to travel, well, so be it."
Other cardiologists are skeptical. While the risk of complications is quite low, why take the chance at all, they counter. The real issue here, they say, is money: smaller hospitals wanting to get a piece of the money-making procedure.
"I am very concerned. This is a market-driven treatment strategy," said Dr. William Schafer, a Toledo cardiologist who performs angioplasties.
Wait for results
Hospital officials involved in the study urge skeptics to wait for the results before jumping to conclusions.
"We would never be looking at this if we didn't think our quality wasn't there," said Phil Ennen, chief executive officer of Community Hospitals and Wellness Centers in Bryan, Ohio.
His hospital is one of the six in Ohio that has applied to be in the study. The research project is being spearheaded by the Johns Hopkins School of Medicine.
Researchers hope to enroll about 40 small hospitals from around the country and follow their outcomes for several years. They want to know if "elective" angioplasties, meaning those scheduled to be done on a non-emergency basis, can be performed safely at hospitals without on-site open-heart surgery capability. Typically, after an angioplasty is done a tiny piece of meshed metal known as a stent is inserted to keep the artery open.
So far Ohio, Alabama, Georgia, Illinois, Pennsylvania and New Jersey have agreed to allow hospitals in their states to apply for the study. Hospitals in those states accepted into the study will be able to do routine angioplasties.