BowTie Medical Blog

The True Cost of the Hidden Harms in Healthcare

Written by BowTie Medical | Oct 24, 2024 8:19:10 PM

In our latest podcast episode, we sat down with Steve Wyman, a healthcare industry veteran, to discuss his personal and difficult journey through a broken healthcare system. Over the course of 14 years, Steve endured nearly 30 surgeries, countless hospital stays, and an overwhelming series of misdiagnoses and complications. Despite his extensive background in healthcare, Steve found himself at the mercy of a system that too often prioritizes procedures over patient well-being. Here are the key takeaways from this eye-opening episode:

Trusting the Experts Isn’t Always Enough

Steve’s journey began with a routine check of his Prostate-Specific Antigen (PSA) levels, which led to a diagnosis of prostate cancer. Despite following his doctor’s advice for treatment, Steve noticed early on that his PSA levels were not following the expected path. His concerns were dismissed until it was too late, forcing him into a series of additional procedures that ultimately left him with severe health complications, including incontinence and infections.

Steve’s story highlights a critical message: always ask questions and seek second opinions. As Steve expressed, “I didn’t ask enough questions… I didn’t get a second opinion. I just did what the doctor told me, and that’s a great regret of mine.” This episode drives home the importance of self-advocacy and taking control of your health decisions.

 

The Problem with Healthcare Miscoordination

One of the central themes of the conversation was the lack of coordination between healthcare providers. Steve described multiple instances where doctors either failed to communicate with each other or didn’t follow up after major surgeries. For example, after his bladder was removed due to complications, Steve’s surgeon never checked in to see how he was recovering. This lack of personal attention and coordination resulted in Steve undergoing a series of unnecessary procedures and prolonged suffering.

Dr. Firouz Daneshgari, who has supported Steve in recent years, discussed the systemic failures that lead to this kind of miscoordination. He pointed out that hospitals, driven by financial incentives, often focus on increasing clinical volume rather than patient outcomes. This lack of alignment between patient care and hospital goals can lead to disastrous consequences for patients like Steve.

The Financial and Emotional Toll of Unnecessary Procedures

The podcast episode also delves into the financial and emotional toll Steve endured as a result of the misaligned healthcare system. Steve explained that if not for his medical complications, he would have stayed in his career for another 10 years, accumulating significant savings for his retirement. Instead, he was forced to leave his job early and has since had to live with financial limitations he never anticipated.

Beyond the financial impact, Steve shared how these procedures and complications changed his life, including severe weight loss and a significant reduction in his quality of life. It’s a sobering reminder of how mismanagement in healthcare can devastate a person’s physical, emotional, and financial well-being.

The Importance of Taking Control of Your Health

One of the most powerful messages from the episode is the importance of patient empowerment. Dr. Daneshgari encourages patients to pause, gather all necessary information, and seek truly independent second opinions before agreeing to major procedures. “No one can make a better decision for your health than you, when you have all the information,” he says. Steve’s story serves as a cautionary tale of what can happen when patients rely solely on a system that doesn’t always have their best interests at heart.

Moving Forward with Lessons Learned

Steve now uses his experience to help others who are going through similar medical challenges. His key advice? Don’t rush into any decision, and make sure to understand what the treatment is, why it’s necessary, and what the potential risks are. He hopes that by sharing his story, others will avoid some of the same mistakes and be empowered to advocate for themselves.

Don’t miss out on this must-listen episode. Steve’s journey is a powerful reminder of how important it is to take control of your healthcare and not leave critical decisions in the hands of a system that can often be misaligned with your best interests.

Click here to listen to the full episode and learn from Steve’s eye-opening experience.

Episode Transcript: 

Firouz D.: [00:00:00] Well, hello everyone. Um, I'm Firouz Daneshgari and it's a pleasure to introduce a person who has become a friend and as a, as a patient, uh, Steve Wyman, I had the pleasure of meeting Steve in a, in a wedding that he was the best man of one of our family members. And after that, over the past probably 14, 15 years, I have, uh, I remain as a, uh, kind of part time consultant to Steve's medical journey, uh, uh, which has been quite impressive in terms of what the sick care system.

and his overzealous providers can do to quality and, frankly, quantity of life of a person. Steve is a very successful professional in actually in health industry. And he could tell you the background and the details. I'm going to leave those up to him. But I just want to do the introduction and go [00:01:00] from there.

Steve, can you tell us a little bit about your background before this whole medical disaster journey started? 

Steve Wyman: In 1985, I began in the contact lens business with a small company called American Optical. Shortly thereafter, American Optical was purchased by SEBA Guide, hence SEBA Vision, where I started with them as a territory set representative initially and moved up into a manager of business development and to a director of business development.

I spent some time as a key account manager and I ended my career of 30 years. Regional manager of academic development for the East Coast in Puerto Rico. I spent 30 years with them. I retired from them when I got sick. I had to, uh, they were generous enough to put me on a year of disability. And unfortunately, when it came up the disability, I.

Still wasn't good and [00:02:00] begin my journey of probably up to 30 operations, uh, and the last 14 years. 

Firouz D.: Thanks, uh, for sharing that. So let us take you back to what was it, 2010 11. So if I understand you had a check of your Prostatic Specific Antigen, PSA, and, uh, that was a little elevated and, uh, so that led to a diagnosis of a prostate cancer.

Your prostate cancer was what we call today low volume and moderate grade in terms of its aggressiveness. Uh, but tell us about, so after the diagnosis of that prostate cancer, what happened from there? 

Steve Wyman: Well, after the cancer was, uh, detected, I went to see a doctor who was recommended to be my, by my internist.

He suggested, uh, radiation, and for six weeks, I did five days of radiation. [00:03:00] At the end of that period, he told me that what my levels would do is they would go up, they would come down to half, and then eventually they'd go to zero. And I followed up with this, uh, urologist every six weeks. And having worked for a medical company, I can read a report.

I'm smart enough to be able to read a report. And every time I'd go back to check, and I'd look at the report, the numbers kept going up. up and up. This started in January and I kept saying, David, there's a problem. Tell me what, what we can do about this. Don't worry about it. Everything's fine. And so in October, 10 months after the fact, he comes in the room and tells me we've got a problem and, uh, we need to attack it in another direction.

And that direction was cryotherapy of which I refused. 

Firouz D.: So, uh, in a summary, you were In a summary, you were diagnosed, you were advised to have radiation therapy, your PSA levels kind of [00:04:00] didn't follow the expected pattern, and then now the question in front of you is to do a cryotherapy, which is freezing, uh, basically the tissue.

Uh, and, uh, just as a, uh, urologist telling you that the cryosurgery and the concept of the freezing the tumor and so forth. Has been tried and has not been successful, at least in curing or eliminating the tumors in various parts of the, uh, urologic, uh, orders that, as far as I know. So, uh, what happened after you were offered the cryotherapy?

Steve Wyman: So, I worked with a lady whose father was a urologist down in Tampa, and she suggested that I sign some HIPAA papers. and send the report to her father, sent him down there and they called me after reading where I stood at that point, he said he can't help me, but he knew a man in celebration Florida that could.

And so I ended up going to celebration and that doctor told [00:05:00] me I needed a, um, Salvage prostatectomy. So I had the salvage prostatectomy and ended up in that hospital down there for almost three weeks after being told I could go home in three days and ended up leaving there with an infection of pseudomonas.

And he sent me actually back to Atlanta and said he knew a guy that could help me in Atlanta. And I went to see him. The first thing he did is remove the catheter. But from that point on, it's been nothing but trouble. Pseudomonas was bad enough, but. And the infection started, and I haven't had an infection in a year.

Firouz D.: Steve, so you did not have the cryosurgery. You did have the salvage, salvage prostatectomy, which is removal of the prostate after Radiation has failed and you had an infection. It prolonged your staying in the hospital. But if I remember correctly, uh, that also give you loss of control of your urine or incontinence.[00:06:00] 

Uh, 

Steve Wyman: what happened with that? Well, basically I was, had to start wearing the Depends because I couldn't control my bladder. I was a hundred percent incontinence. 

Firouz D.: And in the journey you had, they had an artificial urinary sphincter. It's a little device, they put it on. around your, uh, urethra to control the, control the, uh, uh, the continence.

Despite the fact that you had an infection before, which is, uh, kind of a big no no. So, a big foreign body to put there. So, what happened with the artificial urinary sphincter, as we call it, AUS? Well, it was just 

Steve Wyman: never successful. They just couldn't get it to work on a consistent basis. I think they tried three different times, if I remember correctly.

and could never get the instrument to work 

Firouz D.: properly. So that didn't work and then they removed that and then you had another procedure. How did that work for you? 

Steve Wyman: Well, I'm down to a stoma now and my bladder was removed [00:07:00] four years ago. I believe it's been four years now. Going in to think I was having a bladder reconstructed and made out of one of my lower upper 

Firouz D.: intestine.

So you had again in sequence of procedures to, you had an artificial urinary sphincter, a couple of revisions trying to fix it, didn't work. Your incontinence is there. You go and get a neuromodulation called inner stem and that doesn't work and you end up having a removal of your whole bladder. And somewhere about four or five years ago.

If I summarize within less than ten years, going from a moderate kind of, uh, PSA or a low volume PSA and diagnosis of prostate cancer, You ended up having close to about 30 surgeries, if I remember correctly, and then you, and the loss of your bladder. That's correct. [00:08:00] How many hospitalizations do you think you had during this process?

I, I think my last 

Steve Wyman: count was right at 30. I've been in your hospital. I've been in Vanderbilt. I have been to Emory. I have been to Tampa General. I have been to Celebration in Florida. That's correct. Three or four different hospitals in North Atlanta. Uh, so I've, I've seen my share of hospitals in my day.

Josh Taylor: Steve, you, uh, mentioned earlier that in your career, you have been in the healthcare space. You're familiar with healthcare professionals. You're not a stranger to that. Was there a moment throughout this process where your trust in some of the hospital based healthcare system shifted? And can you talk a little bit about that specific moment when it shifted?

Steve Wyman: Without question. Um, It's shifted. It's interesting, having been in so many different hospitals, the quality of care, lack of the quality of care. That's the [00:09:00] difference between different hospitals. Um, I think some of them are just earning a paycheck of the nurses and doctors. And I think some of them are really out there to help you out.

And I unfortunately had some pretty bad experiences in hospitals. I had gangrene. I had, uh, sepsis, um, I just, the, the level of treatment is sad, quite honestly. Um, the trust issue is not there. You have to, there's places I would never go back to because of the way I was treated by both doctors and nurses.

I'll just say that. 

Josh Taylor: Well, and Firouz, there seems to be a regular theme with patients regarding infections. And is, in your experience as a doctor, are you seeing there's a connection between the knowledge about what causes an infection and some of these experiences that Steve had between different health systems.

Firouz D.: So actually, let me point out to this, what Steve says is a lack of quality. Frankly, some of the names of the [00:10:00] hospitals you mentioned, I'm sure if you go to the public database, They're very proud of their reported quality in terms of lack of infection, lack of this and that and so forth. These are the quality metrics that the hospitals must report to, you know, the regulatory agency, most importantly, the, uh, Medicare.

to continue to get their fundings. I think what we are discussing here is lack of really coordination, lack of personal attention to a care of a person that is not a simple, straightforward index case, as we call it in surgery. So someone behind the scene Has to look after the benefit of the patient beyond and above the assembly line that has been set up in the hospitals.

Get a trusted advice that basically bet between the risk and the benefits of the proposed procedure. And those are the discussions that he [00:11:00] didn't have because it goes back to The misalignments that we have discussed, the doctors are so busy. I'm sure every doctor he went to visit, uh, Steve went to visit, he had about less than five to 10 minutes to spend with them.

Which, such a complicated case literally takes about at least an hour to sit down and understand Steve's background. And, therefore, he went one procedure after procedure after procedure. At least, I mean, to begin with, the very beginning one was unnecessary, and then this chain of basically unnecessary care, unnecessary complications start.

And, at the end, Millions of dollars have been spent to deliver unnecessary care to support a waste in the system. At the end, has ruined the quality of life of Steve. Steve otherwise is a healthy person. He could have still worked. 

Josh Taylor: Steve, Firouz just mentioned the harm caused by miscoordination. That there's that lack of coordination in your care that [00:12:00] often leads to mistakes, things being missed.

Can you speak a little bit of your experience seeing that firsthand? 

Steve Wyman: Well, it goes back to the coordination that Firouz talked about, and I can give you one experience that stands out that still angers me to this day. The doctor that took my, uh, bladder out, uh, he had told me what he was going to do when he went in, and obviously I came out with something totally different.

But I never saw him again. He never came to check on me after surgery was over. He never called or his office, never called my house to see how I was doing. And that was not atypical in a lot of cases. I mean, to Firouz's point, I think a lot of these guys are not coordinating with their staff members in order to make sure that that patient, when they leave your care, And that's what I found numerous times 

Josh Taylor: when it comes to the financial impact on a personal level, you know, you had a good job.

I'm assuming you had [00:13:00] good insurance coverage. That wasn't necessarily the problem. Uh, but can you talk a bit more about the impact on your job, your career? 

Steve Wyman: Well, I, I'm sure it cost me, I would have stayed another 10 years at, uh, Novartis if I had the opportunity, which would, you know, I would have made another million or so dollars, and I would have had that much more to retire with that I don't have today.

And so, um, I've had to budget a little more than I ever expected I would, quite frankly. I mean, I live a good life, but still, um, I believe that I would have had a good bit more in my Retirement fund than I do today. And even after I left DeVartis, I accepted some other roles with other companies, but because of these infections, I just couldn't keep the job.

And it cost me a good deal of quality of life for sure. 

Josh Taylor: Was there ever a point where you felt like someone should have stood up in your care? And said enough [00:14:00] is enough. 

Steve Wyman: Absolutely. And I had a guy at Emory and he had kind of said that. And unfortunately when the COVID came along, he just retired. He'd had enough.

And since then I've found yet another one. up here where I live now and he's been really good with me as well. So I, there are some, there are some excellent doctors out there that really truly care. But unfortunately, there's others out there that I believe I wouldn't go back to, or I certainly recommend anybody.

And when I have the option, I'll do a review on them and let others know that, you know, seek us. That's my biggest decision I didn't make. Is I didn't get a second opinion. I heard the word cancer. I got scared. I had two teenage boys and I just lost a friend to cancer and I'm thinking, oh my gosh, I've got to do this.

And so I didn't, I didn't seek out a second advice. I just. Did what this guy told me and and that's a that's a [00:15:00] great regret of mine 

Josh Taylor: What was the thing that brought you and Firouz together? I'm curious about how Firouz got involved when Firouz wasn't one of the actual physicians on your care 

Steve Wyman: Yeah, one of my best friends his wife is Firouz's sister in law And so after I'd been through all these complications Mike knew what I was going through and he the one that suggested that I call Firouz You And so he's been my pillar of advice since then, quite frankly, 

Josh Taylor: I'm curious about when you first heard Steve's story as someone who is a researcher, as someone who's a practicing surgeon in urology, what stood out to you about his story that really caused you say, I want to help.

Firouz D.: So when he was facing complications, that's where our contact took place. But what I want to go back is this whole issue of the, uh, Steve said it very clearly. nicely. The issue of second opinion, the issue of basically the role of [00:16:00] really second opinion on itself to me is not as important as taking a pause, thinking through that.

Do I need this? What are the benefits and advantages? Because actually, the data shows majority of the second opinions over 90 percent of them. The second guy agrees with the first one. And there are a lot of, you know, collegial relationship and all that stuff. But the second opinion and third opinion to me is getting a pause and focusing on the patient.

Say, do I really need this? Do I really would benefit from this? And that is why the role of the guardians comes in again. I never ever tell people what to do. It is their decision to make. Why would I advise you to go and get the second and the third and the fourth opinion? Make yourself the most knowledgeable person in prostate cancer.

Because whoever you go to, they're gonna sell their traits to you. The urologist will sell their robotic [00:17:00] prostatectomy, the radiation oncologist will send you the radiation. You go and get as much information, very much you get information as what, which house to buy, or which college to put your, your sons into.

There is no person who can make the right decision better than you. When you have all the information and that is, I think, what is missing throughout the, uh, throughout the journey. 

Josh Taylor: What I'm hearing you say, Firouz, is that you, when you're getting a second and a third opinion, to make sure that that second and third opinion is truly independent from the same, Mindset of the first opinion, so it's not enough to just go to yet another hospital That's trying to sell maybe some different version of a service But it's the same mindset that we can fix this through more interventions.

You might want to interject a second or third opinion is Outside of those motivations Steve. Did you ever have that conversation with the physicians you're [00:18:00] being with? Laying out of would you be benefiting? 

Steve Wyman: I did not. And I accept responsibility for that because, as we've already said, you go to these guys because they're experts and you expect them to do what's in your best interest.

And I believe some were trying in my best interest. I believe there are others that weren't, quite frankly. 

Josh Taylor: If you could go back, what's a couple things that you wish that you would have said or done outside of the second opinion? 

Steve Wyman: Yeah, I mean, I, and to Firouz's point, what I should have done is researched the numbers, the PSA numbers, and, and known what's good, what's indifferent, what's not to worry about, uh, talked to some, I've got many, many doctor friends, I should have gone to them and talked to them, and those are questions I, you know, I kick myself to this day that I just, I didn't do.

I just took the word of, you know, The practicing physician that I was seeing at the time. 

Firouz D.: Steve, let me give you a little relief because [00:19:00] I don't think you did anything wrong. There's a misalignment in the system. And you as a patient, you have the right to trust the doctors. It's a privilege to be a surgeon.

You know, you take people's lives in your hands and that trust, I don't think any surgeon violates that. His job or her job is to do the surgery and your job is to trust it. But the system has created this misalignment. There's a gap. If you want to go and buy a company, frankly, right? You're a businessman.

You go and just don't write a check into a company. You go and get a bunch of advisors. Just tell me what are the future of this, basically, future of this company. What are the competition? All that stuff. The fact is, the hospitals, the health care that you go to and you use it, Now it's delivered for 5, 000 hospitals.

You have experienced at least 10 of them. These hospitals have become financial institutions that derive basically their [00:20:00] margins based on clinical volume. These financial institutions are not held responsible for the outcomes that they deliver to you. And that is where the gap in the system is. That's the gap that they, A group, an agency, we call it the health guardianship, should be there to help you to understand the, uh, the implications of all these major decisions.

Josh Taylor: Steve, you're, you're, you've been in business, you're in training, obviously in training you give feedback. If you were to be able to sit back down with some of the doctors and surgeons that treated you along your care path, What feedback would you provide them so that they could be better and hopefully not repeat some of the same patterns that existed in your care?

Steve Wyman: Well, what I would say to them is, tell me why we're doing this procedure. What's my benefit? How am I going to benefit from this procedure that you're doing? I didn't ask enough [00:21:00] questions, and I'd even like to go back and talk to them to this day, quite frankly. And say, you know, since we went through these procedures My life right now is pretty good, but for a long, long time, it wasn't.

And do you think some of the procedures that you did on me contributed to my Poor health for so long. I think that's a fair question to ask 

Josh Taylor: for is what questions Do you think should be asked for physicians that go through because sometimes to your point? There's a misalignment in the system. Some providers are trained that hey, this is how we treat this But what questions if you're a doctor listening to this if you're a nurse listening this What should you be questioning when it comes to care plans like this?

Firouz D.: My advice to the doctors are, uh, are, uh, question your role in the system, in the sick care system. And that is, as you know, was my own wake up call that I realized I've become a cog in the wheel of a financial [00:22:00] institution. that wants to drive a financial margin from clinical volume. The problem with clinical volume is, this is dealing with people's health and, uh, longevity.

The more we do, the more harm we cause. And this is, we have reached, uh, a point, a reflection point in the U. S. that because the healthcare is delivered by these 5, 000 hospitals that are financial institutions, The amount of unnecessary care has risen to over 50%. Half of what we, what is done in this hospital systems are a waste, as is reflected in Steve's story.

And the second, and then hospitals to support this, they keep hiring the doctors to basically support that structure. My question to the doctors, and doctors know it by their heart, as soon as they listen. that question basically your role. Your role when you took the Hippocratic Oath was to cause no harm, solve people's medical [00:23:00] problems, not to support the financial aims of the hospital.

The second issue I have with the general public is someone is paying for this waste, and that is you, and I believe that is led by the federal government. Federal government, they pay for this waste based on the cost plus issue, because they regulate the payments to the hospitals, and the private insurance companies follow that.

The third party payer, led by the government regulations, is paying for this waste. And that must stop. That's why I advocate a A free healthcare market where individuals coupled with their primary care, with their health guardian could take, take control of their decision making that is done by controlling the money, uh, so they can decide where their healthcare money is spent.

As we have discussed in the past, between the age of 26 to 65, we spent $1.2 million out of our earnings to pay for the premiums of our health [00:24:00] insurance. And someone else is making this decision for us. The time has arrived for us to get the control back to the individual. Individuals have a choice. And the mechanics are very actually clear out there how this could be done.

And take the control back to individuals and Disrupt and deconstruct this misaligned system. 

Josh Taylor: Steve, uh, couple last questions as we wrap up here. How, how do you share your story with others? What are you trying to share? I'm assuming you're relaying what you hoped you had done in the past so that other people can avoid the same fate, but how do you typically use your story when helping other people?

Steve Wyman: Well, interesting question. I actually have a friend of mine in Panama City who had a close friend who was, uh, had the same issues that I had, prostate cancer. And, uh, that gentleman and I spoke and I basically just shared with him my story of all the different doctors and all the different surgeries and all the different issues that it caused in my [00:25:00] life.

And I tell you, he couldn't have been more appreciative of that than anybody. So. Everybody close to me knows what I've been through, they've seen it. And so, they'll come to me and they'll say, What do you think? What would you do? I would say, think about it, research it. Find out what's in your best interest.

Find out what the numbers are, what they're trying to cure, and is this surgery or procedure actually in your best interest? Probably the biggest thing that's happened to me over and above all the surgeries is, I've lost a great deal of weight and I can't put any on. And it's apparent to all my close friends, I just thought the same person physically that I once was, it's changed my life significantly.

Josh Taylor: Well, Steve, I really appreciate you sharing your story because many people don't want to talk about some things like this. They don't want to share some of the long experience because it's already been long enough. But you being willing to talk about it openly, I think is [00:26:00] not only informing and helping other individuals, But hopefully it's helping to stem the tide of some of these procedures happening.

If other providers can hear it. 

Steve Wyman: Well, thank you. It's been my pleasure. 

Firouz D.: Yes. Thank you, Steve. I want to express my thanks to you as well. Uh, as it's not, it's not easy to kind of, uh, review the many years of the discomfort and so forth. I'm, uh, Happy you're, you're content now. Uh, but, uh, I think your case truly is misalignment, dysfunction in the system.

And as you know, we are in the year of election and one of the hot topics on the table is the healthcare. And there's no question in my mind that the government sponsored healthcare in, under any shape or form, Is going to exaggerate this process is going to increase the costs and so forth. The only solution we have is to take control back, but I really want to thank you for helping us [00:27:00] to kind of bring this message to the consumers, to the doctors and, uh, you know, uh, to all the Americans.

Thank you, Steve. 

Steve Wyman: Well, thank you for, like I said, I've been my pleasure. 

Josh Taylor: Right. Well, everybody, I appreciate, uh, you joining and, uh, we will talk soon.