Veith’s Viewpoint: Good doctor, good medical care: priceless

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Today all we hear about is the high cost of U.S. health care, and how for our country to survive economically, it must cut doctors’ payments and spend less for health care, drugs, and medical devices. Certainly there is waste in the system and some physicians perform procedures that are unnecessary. But when one really needs good medical care and a good doctor, they are priceless.

Dr. Frank Veith

Two recent dramatic examples in my own family made this clear to me. In one, a loved one developed a staphylococcal infection at an epidural injection site. Within 24 hours, she was desperately ill with a temperature of 104º, shaking chills, and excruciating back pain. She was expeditiously admitted to the ICU of an excellent community hospital and started on massive IV antibiotics. She underwent an urgent MRI, which revealed a paravertebral phlegmon. Blood cultures grew Staphyloccus aureus. She was seen repeatedly by her intensive care specialist and her orthopedic surgeon. When she did not improve, her orthopedic surgeon obtained a second MRI 36 hours after the first one. This, unlike the first, revealed an epidural collection, and she promptly underwent a three segment laminectomy to drain the abscess.

Although she required a second drainage procedure and careful adjustment of her IV antibiotics, she survived without any neurologic or cardiac damage. During her complicated and onerous 2½ weeks in the ICU, she was seen 2-3 times a day by both her intensivist and orthopedic surgeon, as well as by a variety of other specialists when they were needed. All made essential contributions to her recovery from this life-threatening illness. The skill and commitment of all these doctors, especially the orthopedic surgeon and the intensivist, made the difference in saving this young life. The care she received was priceless.

The second instance involved the cure of a life-threatening ventricular arrhythmia in a relatively young, productive individual. Although asymptomatic, this individual was having over 40,000 ventricular premature beats with runs of ventricular tachycardia in a 24-hour period. A highly skilled team of super-specialists in cardiac radiofrequency ablation procedures successfully eliminated the focus of these arrhythmias. However, the procedure was difficult and complicated. It took 7 hours and required both left and right heart catheterizations and crossing of the atrial septum and the aortic valve. Despite this, the individual was back at his usual work in 3 days, completely arrhythmia free. He has required no further subsequent treatment.

In both instances, the good care required by these skilled specialists and their colleagues was complicated and demanding but successful. It required enormous expertise and, more importantly, the commitment and dedication of those providing it. Sure, this care was expensive, but it was worth every penny. It was priceless, because the outcomes were life-saving and perfect. These priceless treatments restored two young, productive people to full health.

So in this rush to cut health care costs, let us remember that we in the United States have the best physicians and surgeons, the best hospitals, the best drugs, and medical devices in the world. Let us preserve these assets and not kill the goose that is laying the golden eggs of health care. Let us preserve and reward the priceless individuals and priceless care that can allow many of us in the United States to lead better, more productive lives than we otherwise would.

Dr. Veith is Professor of Surgery at New York University Medical Center and the Cleveland Clinic. He is an associate medical editor for Vascular Specialist.

The ideas and opinions expressed in Vascular Specialist do not necessarily reflect those of the Society or Publisher.

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