Provocative Angiogram

@beahind - Please answer this question. Is your cardiologist a Mayo Clinic cardiologist or one from outside Mayo Clinic? The general answer to your question is "Yes, a doctor may insert a stent during your angiogram, if during the test it is deemed that one is medically warranted-nessary." Here is the tricky part. Not all doctors make the decision to install-insert a stent(s) alike, and based upon exactly the same insertion-installation decision criteria.

Let me try to put this politely. For some doctors, the quality of your health insurance (i.e. whether the doctor can get easily paid/approved for insertion of a stent(s), will influence the doctor’s decision to stent or not to stent.) impacts their medical decisions. One of the advantages of being treated by a Mayo Cardiologist is that they are not in the Medical Money-Making Business, only the patient-focused doctoring business. They only do “Doctoring” focused on what is best for the patient, not what is best for Mayo’s Bottom-Line. The Business & Finance part of Mayo Clinic handles the money worrying and money-making part of the medical, healthcare business, not the Mayo Doctor & Medical Team treating you. Mayo Doctor gets paid the same whether they put in zero stents or 100-stents.

I can speak from my personal experience. I have one of Mayo Clinic’s “Top Doc” Cardiologists. I am 76, therefore, my blood vessels had some blockage present here and there, but the %-numbers fell below the Mayo Clinic Cardiology criteria numbers to require and call for insertion-installation of any stents. Had I received my angiogram from a non-Mayo Clinic source and doctor, it is more likely than not that a non-Mayo For-Profit Cardiologist would have installed-inserted a stent based on my blockage %-numbers…because my heath insurance would have approved it and covered it.

So here I sit typing this Mayo Connect note to you. I am stent-free, and not on any medicine-medication associated with follow-on, maintenance treatment following insertion-placement of a stent(s). I do not have to concern myself with any medication side-effects or any down-the-road stent-associated maintenance treatment, replacement attendant to having stents resident in the human body. The reason is because I chose Mayo Clinic Cardiologist over a For-Profit Cardiologist to evaluate my cardiac health, and to doctor me in a What-Is-Best-For-The Patient-focused manner, not a bottom-line focused manner.

Cardiac health-wise, I am told it is likely that it will not be cholesterol-blocked, obstructed blood vessels that will cause my ultimate departure from the planet. I like that Mayo Clinic Cardiology health assessment.

I wish you the best of luck with your angiogram, cardiac health evaluation and assessment results. Best-Case you may not need a stent(s), as was my outcome. However, if a stent(s) is called, you will be better off with them present in your arteries, rather than without them being present.

Have a Barbecue-licious & Patriotic Independence Day 4th Of July.

Thankyou for the information. That part of the situation hadn't occurred to me. I'm Canadian so the insurance factor doesn't come into play for me as much because our government audits doctors to ensure that they are conducting business professionally. I hope not to have stents as well. It seems incredibly invasive but I will go with what the cardiologist tells me.

@beahind - Alas, we here in the "Colonies" are on the cusp of celebrating the 241st Anniversary of our 1776 Declaration of Independence from Britain, so forgive me if your response got my Red, White & Blue up a tad.

Not to start a cross-border “Whose Ugly Baby Is Prettier” contest between we Colonialist "Yanks," and our North American good neighbors & friends up in Canada. However, your intended or unintended implication that your socialized Canadian Healthcare has superior government bureaucrats who assure “the insurance factor doesn’t come into play as much because our government audits doctors to ensure that they are conducting business professionally” does not pass the smell or my experience test with socialized medicine, as I saw it being deliver (i.e. parsed out) in Canada, the UK, and Europe. We, in the US, have the equivalent “Bureaucrat Gate-Keeper Folks” who “audit doctors to ensure that they are conducting business professionally.” Can you spell “Medicaid/Medicare Fraud?” Here in the US, you do not have to queue up, and wait in a long waiting lines to receive specialty medical care. A friend of ours father who resides in the UK, who was in his mid-80s, died from associated complications, while being queued up in UK Healthcare Delivery line waiting for 18-months to receive the Benign Prostatic hyperplasia (BPH) Urology treatment he required, but that he never received because he died from associated urology/kidney complications while waiting, waiting, waiting....

Do not believe what you may be seeing on the news. Our “Bad” US system is a comparatively “Good” US system. I am walking and 76-years of living proof of it. It is this current attempt to socialize our US healthcare, which is causing the current political “Dust Up.” My point is it, a Pseudo-For-Profit Private or Government-Run healthcare delivery system is not the results-proven, 153-year old, patient-focused medical care delivery system that is Mayo Clinic doctoring.

Answer me this, will your Canadian Government Healthcare let you opt to travel cross-border to Mayo Clinic Rochester, Florida or Phoenix to receive cardiology evaluation, assessment, and medical care? My current US Government healthcare insurance lets me, and has let me/a family member travel from Florida up to Mayo Clinic in Rochester, MN to be treated by an Internationally Renown Cranial/Micro-Surgeon at Mayo. My US Government Health Insurance covered it, and that US Government Health Insurance does not need to be “Fixed.” We just need to figure out how to extend health insurance to more people without ruining the current US healthcare delivery system. It helped get me to 76-years old. I am happy with it, as well as my family member who needed the #1-In-The-Country-Cranial/Micro-Surgery Surgical Care, being happy with it.

The problem is, government & private insurance company audits be damned, there is “Professional-For-Profit” doctoring, and there is “Professional Mayo Clinic Patient-Focused” doctoring. “Caveat Emptor” applies to anything you let “Medical Professionals” do to your body.

Hi @beahind,
Welcome back. I took the time to review your posts so far on Connect in this discussion thread:
- Chest pain conflicting diagnosis https://connect.mayoclinic.org/discussion/chest-pain-conflicting-diagnosis/

Were you diagnosed with Prinzmetal angina afterall? When do you see your cardiologist?

I unintentionally got your blood pressure up there. Didn't mean too imply that ours was better or worse. Truth be told I envy you your access to Mayo. I'm going with the best available to Canadians (as you say I have no choice anyway really) and was very lucky to get in in six weeks. From my research the facility has a good reputation so I'm hoping for the best.
Travel can't be avoided in my case as I live 1000 miles into the frozen north.
I have some experience with the U.K. Irish system as well and I know what you mean. There's nothing quite as heartrending (or entertaining) as a trip to a rural Irish hospital, although I'm told that the larger centers are better. I spoke to a family there who sold their home to pay for heart surgery for the father. Tragic.
Our system seems so random sometimes (my daughter had a six hour surgery within four days of discovery: my father waited three years for knee surgery) very much depending on the doctors triage. As Vasospastic patients can testify, doctors don't always get it right.
A note that you may not be aware of (to bolster your argument) Canadians and U.K. Citizens who can afford it tend to buy addition extended health insurance anyway. Doesn't shorten the wait list but covers a nicer hospital room, meds, that sort of thing. So I'm paying through taxes for the public system and privately for extended care. Don't know how the cost would stack up against what you pay but it would be interesting to do the math.
I don't know anything about your system other than an American dentist friend who loves his HMO and a movie I saw years ago with Denzel Washington. Not meaning any disrespect here but a lot of Canadians don't pay any more attention to American politics than we would to European (although there are many who are commendably better informed than I am).
Our political system is so messed up that's it's a full time job just keeping up with it. Can you imagine a Senator appointed to the position for life who is under no obligation to show up and has no influence on policy anyway? Even the brits made the House of Lords elective.

Hi, @catgic. Your passion for Mayo Clinic is admirable. Many people travel from all corners of the world to benefit from Mayo's expertise. I also see that you have strong views about a healthcare system that has worked well for you and your family. Obviously Beahind's post struck a chord with you. However, in my opinion, it was not a challenge about the merits of anyone's healthcare system. As you said, let's "not start a cross-border “Whose Ugly Baby Is Prettier” contest ..."

Connect is open to all patients and family members around the globe being cared for in whatever healthcare system they have access to. For some, travel to the US may be possible. For others, it may not be. Wherever people are treated, as fellow patients and caregivers, we can provide our experiences, information and support.

Yes I have the diagnosis of Prinzmetal Last Thursday. I finally bypassed my GP and called the cardiologist myself, respectfully taking issue with his diagnosis of Esophagela spasms and they put me in sooner. I have an angiogram tomorrow and have read ( in more than one forum) where patients have regretted allowing the surgeon to stent so am therefore a tad nervous. Not that I have a choice really. My health has now been compromised to the point where staving off permanent damage is my first priority. Catgic has an excellent point - if you need them, get them. My confidence in the medical system is shaken at this point but I trust my cardiologist. Not condescending, listened to my concerns, didn't interrupt ... who knew?

Thanks for all of your postings @beahind. It only now occurs to me to ask: What is the role of second-opinions in Canada's system? They are vital to physician effectiveness in the US.
Martin

I like your comment @colleenyoung. I'd like to add a couple of thoughts. I thought @catgic was primarily concerned about the quality of medical care given to patients rather than the quality of the broad health care system. And as you no doubt know about me, I have strong feelings about patient care as well. Also second opinions by competing medical professionals are very important -- not only to make sure of a diagnosis and a treatment plan and feel confident about it, but also to help identify medical professionals who are consistently right on both counts for numerous patients.

Mayo Connect and you perform marvelous services for puzzled patients, and most of the time what those patients learn from discussions here on Connect is valuable information and advice. I worry, though, when I see a suffering soul who is in great need of a clear understanding of her/his needs, but too easily settle for partial or poor advice from another discussant who succinctly says, "It worked for me! You should try it!"

Second opinions are vital responses in such circumstances, but not always possible under the troubled patient's financing arrangements for health care. Sometimes, in fact, the patient can't access even their primary physician in a timely manner, let alone track down an alternate medical professional, get an appointment for a secondary opinion, and get insurance/Medicaid/Medicare agreement to pick up the tab.
Martin

When a patient disagrees with any diagnosis they get a referral to another specialist. In my case I did some research to find the cardiologist of my choice. Although my GP disagreed with the need he could not deny me - and would not deny me either. He is a good man. You cannot demand tests (I don't think) but you can demand to see whomever you want. The worst they can do is tie you up in wait list purgatory or lecture you as to how you are burdening the health care system. The internal medicine specialist was quite stern and dismissive with me over the cost I wanted to incur the tax payer by insisting that we pursue a heart diagnosis beyond a normal stress test. He told me that no reputable cardiologist would continue testing. Thank goodness for the internet.