An Oregon neurosurgeon has a "troubling" pattern of performing repeat spinal surgeries on Medicare patients, reports the Wall Street Journal in a detailed analysis of Medicare database records. But is Vishal James Makker, MD, actively defrauding his patients and the system, or is he, as the surgeon claims, simply serving a difficult patient population that other doctors won't touch?
It's a distinction not many surgeons would brag about: Dr. Makker, a 41-year-old neurosurgeon based in Portland, performed 39 additional spinal fusions per 100 initial fusions on Medicare patients in 2008 and 2009, the "highest rate in the nation among surgeons who performed spinal fusions on 20 or more Medicare patients during those two years," reports the Journal.
The article highlights the case of Ronald Johnson, a former machine tool operator who had 6 spinal surgeries performed by Dr. Makker in less than 2 years. Mr. Johnson, 62, who says he felt progressively worse after each procedure, sued Dr. Makker for malpractice in 2009, claiming that the doctor performed "unnecessary surgeries" on him. The parties reached a confidential settlement in the case last month.
In e-mails and text messages sent to Journal reporters, Dr. Makker attributed his relatively high rate of multiple fusion procedures to difficult cases he received from other area doctors who don't accept Medicare patients, and to implant failures associated with a supplier with whom he no longer works.
The "main reason that I have had so many repeat surgeries" is "honestly, I am the dumping ground for Medicare patients, especially the difficult ones that everyone knows are going to be difficult to fix with one or even two surgeries," he wrote.
But spine surgeon Charles Rosen, MD, president of the Association for Medical Ethics, counters, "When you get to numbers like six and seven surgeries on someone's spine in a short period of time, that starts to be suspicious."
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Irene Tsikitas
