Beaufort County residents, your health and health care are in jeopardy.
Resources to pay for health care are falling victim to professional ineptitude, negligence, malpractice and inappropriate billing to yourselves, insurance companies and Medicare.
Costs are rising and will soon consume an untenable 20 percent of U.S. GDP. It's partly due to the increasing complexity and cost of medical care, but to a greater extent, it's due to unconscionable misuse, abuse and waste involving unnecessary procedures and charges, done not for the benefit of the patient, but too often, for the benefit of the provider.
Health care literature estimates that 25 percent to 30 percent of all medical expenditures are wasted.
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We don't claim that all, or even most physicians, locally or nationally, are guilty, but too many doctors abuse the privileges and responsibilities of being a licensed physician. By their unprofessional behavior, they impose a disproportionate burden on the system.
As retired professors of medicine with aggregate experience of more than 100 years in medical research, patient care and teaching medical students, physicians-in-training and those in practice, we think we have the experience, knowledge and responsibility to make these statements.
Patients rightly expect their physician to provide medical care without worrying whether a conflict of interest exists between themselves and their doctor. Medical ethics require that the patient's interests always come first. Ethics and law require the physician to inform the patient when a conflict of interest exists.
Concerned that professional standards are increasingly being violated, both because of professional misbehavior and unrealistic patient expectations, nine national medical specialty societies joined to publicize their recommendations. The objectives are responsible cost containment and avoidance of unwarranted test-related complications.
The American College of Cardiology specifically recommended that stress cardiac imaging or advanced invasive imaging shouldn't be done in initial evaluation of patients without cardiac symptoms, and annual cardiac stress imaging shouldn't be a part of routine follow-up in asymptomatic patients.
After reviewing one patient's records, we are aware of a physician who, in contradiction to the guidelines, over eight years ordered many expensive and potentially dangerous radiation tests for a patient without justification, even for the initial test, and with all tests revealing essentially normal findings.
At the same time, the patient suffered from a readily recognized, yet undiagnosed and untreated, serious medical problem, despite more than 30 office visits and five hospitalizations.
Is it pure coincidence that these expensive and potentially harmful tests, costing more than $10,000, were performed in facilities owned by this physician and his partners?
When physicians, driven by financial reasons, order tests to be done in their own facilities, without adequate training to provide effective supervision, performance and interpretation, they can further endanger the patient with sometimes erroneous results.
Unfortunately, some patients believe that more testing is better (especially if someone else pays), favoring doctors who do many tests, which are irrelevant at best. Due to inherent dangers of some tests, overtesting can produce worse outcomes, not benefits.
This behavior must be stopped and soon because it threatens patients' welfare, the viability of our health care system and the national economy.
These physicians, even if a minority, must be identified and sanctioned by their colleagues who value professional principles. Local physicians, some of whom are aware of this situation, must not shirk their obligations to their profession, their patients and society.
Addressing these issues, an editorial on professionalism in the medical honor society journal, "The Pharos" starts with: "Medicine is based on a covenant of trust, a contract we in the profession have with patients and society."
That says it all.
We know other patients suspect similar problems with their doctors, but they, too, have generally remained silent. They must be proactive, inform their friends and fellow patients and together ostracize medical transgressors who disgrace the profession. It's simple. If you cannot trust the integrity of a physician, you should not entrust him or her with your life.
Contrary to current politicized rhetoric, it's irresponsible behavior by providers that really threatens the future health care of yourself and family.
In the U.S., we can and should (but don't) have the best medical care system in the world. We must do better.
Engelman and Field are graduates of the Harvard Medical School, trained in internal medicine at the Massachusetts General Hospital, were research investigators at the National Institutes of Health, and are professors of medicine emeritus from the University of Pennsylvania (Engleman) and the Baylor College of Medicine (Field).