Nursing Book Club

Coronary: A True Story of Medicine Gone Awry

With the help of hoodwinking, a cardiac surgeon turns a community hospital into a cash cow

By Stephen Klaidman
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Reviewed By Christine Contillo, RN, BSN

Nursing Book Review: CoronaryIf you are like me, you probably wonder why hospital bills are so high. It certainly doesn’t seem as if our salaries ever climb enough to justify the cost of a stay. Or maybe you’ve wondered if a second opinion is really necessary when doctors just seem to vouch for each other when it comes to differences of professional opinion. Then again, maybe you’ve heard stories about how hospitals seem to keep patients just until their insurance runs out and then pronounce them cured. Hopefully none of this goes on at your facility, but a few years ago it was big news in northern California.

Coronary: A True Story of Medicine Gone Awry by medical journalist Stephen Klaidman follows the transition of Memorial Hospital, a small community hospital founded in Redding, California, in 1945 by a solo practitioner. Seven years later, a board of investors, including some local physicians, purchased the growing hospital. In 1972, it was sold to National Medical Enterprises, later called Tenet Healthcare Corporation, and in the 1980s was renamed Redding Medical Center. The hospital, one of two in the area, was then rebuilt from the ground up and became a cash cow for the for-profit corporation which now owned it.

Much of this profit became possible through the services of an aggressive, ambitious cardiac surgeon named Dr. Chae Moon, who dominated a region in which he had little competition. He was able to perform cardiac procedures faster than anyone else around. Dr. Moon was able to convince the hospital to open what became the California Heart Institute, where he performed four or five times as many cardiac catheterizations as were done anywhere else in the state, including at the major medical centers. His patients often moved from stress test directly to by-pass surgery, sometimes without any symptoms at all. All this in an area with a population of only 85,000.

Were the residents of Redding sicker than anywhere else in California? Did something cause them to develop severe cardiac disease at a younger age? Or was Dr. Moon able to use technology to diagnose problems where no one else could find them? What did the other practitioners at the hospital think of him? We know that statistically, surgeries can have adverse effects, but is there compensation due when a patient suffers during a needless surgery?

It was a very worldly Catholic priest who first blew the whistle after receiving a very different second opinion and initiated a federal investigation. Learning about the legal maneuvering that follows is fascinating, and it’s amazing to discover how the politics behind the operation of medical centers really works. The author helps to distinguish the criminal procedures from the financial, and lets you understand how the courts view the moral obligations of physicians. It also gives you a window into how hospital boards operate.

While the book is sometimes more detailed than might seem necessary, it’s clear that Klaidman wants you to understand exactly what happened in Redding, and in the process you will become a better healthcare advocate. The cover jacket claims it is a “medical mystery,” but in fact it’s also a textbook to deciphering how the public can be hoodwinked by fast-paced jargon and some fancy diagnostic machines.

Written By Christine Contillo, RN, BSN, a nurse since 1979, has written extensively for various nursing publications as well as The New York Times.

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