With this device in your chest, an Elvis suit for the doc?

The April 3, 2011 NY Times has a nice piece about pacemakers and AICDs from a little-known and low market share German device manufacturer, Biotronik. Apparently this company's pacemakers have pretty much cornered the market among cardiologists at University Medical Center in Las Vegas.

(By the way, the Times has gone to a pay-wall, so the above link to it can't be counted on to work for too long after this posting comes out. Try a search engine. There's no permalink as one used to use to make sure the link stayed put.)

In any case, how fitting it all seems in anything-goes Nevada. According to the article the Feds may or may not be going after this egregious example of conflict of interest. Let's hope they are. But at least we can make sure that what plays in Vegas doesn't stay in Vegas.

Apparently some of the cardiologists at UMC are (or were) pulling down up to 5k a month in consulting fees. That may or may not have anything to do with the fact that the small German device-maker went from having, oh, zero 2-3 years ago to 95% of all devices implanted there last year, by total number of patients.

Good work, gentlemen. Let the word go out. Come to America and roll the dice in Las Vegas. It's almost enough to make me want to become a brimstone-spouting right wing pastor. "To gamble, it's of the devil."

But this is a place where the state's new governor is a former chair of the gaming commission.

Of course, the real culprit here is, collectively, those cardiologists and the middle-man distributors who court them. According to the article, the cardiologists who didn't enroll their patients (and presumably take dough) were on what the sales guys called the "loser" list.

Yes, "winning" in health care is about market share and effective sales. No surprise here. We knew that already, of course, from Wendell Potter's Deadly Spin, with which most readers of this blog are no doubt already familiar.

It sure as hell isn't about the patient winning. But last time I checked, professionalism and the Hippocratic Oath have something to say about the patient being the one who's supposed to win.

One understands that these gotta-make-a-buck middle-men, and the device vendor-manufacturers, are interested in the almighty share. Birds gotta fly, fish gotta swim. But the doctors--a sad commentary indeed if, as this articles says, "[they] then did the rest."

In this same vein, loss of meaning, clearly the word "university" in hospitals' names has ceased to have much real meaning. The article says the hospital CEO never bothered to ask the docs whether they had a conflict of interest.

Alas, too often that's equally true across the rest of the country. "University" centers behave just like proprietary players, as anyone reading this blog can't have failed to notice.

Maybe just a wee bit more glaring in Vegas, though, where guys in Elvis suits fall out of the sky and pay-to-play pacemakers fall into patients' chests.