This editorial appeared in The (Raleigh) News & Observer.
As doctors, patients and insurers gathered Tuesday in Greensboro for one of the Obama administration's regional sessions on health care reform, a newly released report on heart surgery charted one of the baffling inconsistencies of our present system.
In North Carolina, it turns out, where a heart patient lives has a lot to do with whether he or she will get bypass surgery or a less invasive procedure, balloon angioplasty. While there may be good reasons for opting for either form of care (or more conservative treatment) in a particular patient's case, geography wouldn't seem to be among them. Yet in Fayetteville, for example, surgeons perform bypass operations more often than angioplasties, even though the latter procedure is much more frequently chosen in the state and nationwide.
Fayetteville, in fact, is a hotbed of heart bypass surgery, judging by city rankings from the Dartmouth Institute for Health Policy and Clinical Practice. The home of Fort Bragg is No. 3 in the nation in the degree by which coronary bypass surgery outpaces angioplasty.
Judged in isolation, it's hard to know what to make of that tidbit – or the N.C. Health Access Coalition's finding, based on Dartmouth data (on Medicare patients), that Smithfield heart patients are far more likely to go the angioplasty route. What we can say is that doctors' preferences for one procedure or the other, perhaps based on their training and equipment, appear to be driving the choice of treatment to an uncomfortable degree.
To read the complete editorial, visit The (Raleigh) News & Observer.