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Health report-card fears make doctors forgo potential life-saving heart treatment

Nearly 80 percent of interventional cardiologists in New York State admit they have avoided performing a risky but potentially life-saving angioplasty on a patient, out of fear that if the patient dies it skews the doctor's personal mortality "report card," according to a University of Rochester survey.

The anonymous poll was designed to measure whether the state Department of Health's system of tracking doctor's cardiac death rates has an impact on how doctors make treatment decisions and what types of patients they choose to accept.

The study published in the Jan. 10 issue of the Archives of Internal Medicine found that 79 percent of New York interventional cardiologists polled responded that they have made decisions about accepting critical cases into their cardiac catheterization labs that hinged on how the outcome would affect their state mortality data report card.

New York is one of only a handful of states to publish mortality data in an effort to raise consumer awareness about physicians' and hospitals' records, and more states are considering adopting the practice. Many medical professionals, though, have long suspected that these report cards may influence some physicians to avoid taking critically ill patients to the catheterization lab, even though the patient might benefit from angioplasty, because of the possibility of adding a potential death to their files, says principal investigator Craig Narins, M.D., an interventional cardiologist.

"While these reports attempt to provide the public with objective information about physician quality, they can in some instances create a conflict for the physician that may actually worsen patient care," he says.

For the study, an anonymous, one-page questionnaire was sent to all interventional cardiologists in New York - 186 physicians - who were included in the angioplasty report released in January 2003. They were asked to respond to nine statements regarding the state mor
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Contact: Karin Gaffney
karin_gaffney@urmc.rochester.edu
585-275-1311
University of Rochester Medical Center
10-Jan-2005


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