Do I sell heart scans?

I came across a criticism of the Track Your Plaque program recently that suggested that it was nothing more than a program to sell CT heart scans.


I suppose if you say that the Track Your Plaque program is nothing more than a way to sell heart disease prevention, omega-3 fatty acids from fish oil, vitamin D, better nutrition, and better identification of causes of heart disease . . . well, I believe that would be true.

But is the program a "front" to sell heart scans?

No, it is not, nor has it ever been.

I've heard about these peculiar suspicions about the program before. Though I've never taken them seriously, let me clear up any lingering uncertainty:

--I have no relationship with any heart scan center, scanning facility, or hospital other than to interpret heart scans.

I do not own a scanner, I have no financial interest in a scanner or scanning center, nor have I ever had any interest. I also have no plans to do so in the future. Let business people in the imaging business do that. I want no part of it. I have seen what these people go through and, frankly, I want no part of it, nor do I want the appearance that I am advocating scans to make money. I'm accused of trying to make money from scans even when I do not have any financial interest!

--I do not sell heart scans or imaging packages, nor have I ever done so.

You can't buy a scan through Track Your Plaque, The Heart Scan Blog, or through me. To me, heart scans are simply a measuring tool to identify the extent of coronary plaque, as well as a tracking tool to follow its course. Without it, there would be no Track Your Plaque. But there is also no alternative. The closest alternative would be carotid intimal-medial thickness, a technique, while useful, is a distant second choice to indirectly gauge coronary plaque by examining the thickness of the carotid lining (not carotid plaque). Perhaps in 10 years, a better measure to gauge and track coronary plaque will emerge that has superior aspects over CT heart scanning. If reasonable, safe, accessible, and quantitative, then Track Your Plaque may adopt that technology as its measuring tool.

Track Your Plaque is not about heart scanning; Track Your Plaque is about measuring and tracking plaque that, in 2008, is still best accomplished with CT heart scans.

--I make loads of money from heart scans and Track Your Plaque.

Yeah, right.

Track Your Plaque is a volunteer venture for my team; none of us get paid a penny for doing all we do, including me. We charge a membership fee on the website (somewhere around $6-7 a month) to pay our expenses, such as code writing for our proprietary software (much of it remains under development), printing costs, modest legal costs, the costs of doing business (e.g., accountant). Despite the fact that Track Your Plaque and the Heart Scan Blog occupies a substantial part of the day of the Track Your Plaque team, none of us are reimbursed for our time. I do believe, however, that this concept is so enormously powerful that it will, someday, pay us all enough to allow us to devote more time and effort to it.

Personally, I can't wait to devote more time and effort to this concept that is simple, logical, and effective. More research is needed, more development is needed, more discussion is needed. Right now, it is all accomplished outside of our busy schedules, including my full-time cardiology practice. I continue to have 7 am procedures, middle-of-the-night calls, weekend hospital rounds and emergencies (though virtually none of these are the patients involved in prevention, but the "other" people: atrial fibrillation, elderly heart failure patients, rhythm disorders, cardiomyopathies, pulmonary hypertension, peripheral vascular disease, the non-compliant).

--The book, Track Your Plaque, is a gimmick to sell you a heart scan.

No, it's a program that relies on this technology. But there's no special deal, no discounts, no steering to heart scan centers that I have a special arrangement with. No such thing exists, nor has there ever been such an arrangement.

I've heard it all. Early on, when I was helping my friend, Steve Burlingame and his wife, Nancy, set up Milwaukee Heart Scan, I helped by providing medical oversite, education of physicians and public, and interpreting heart scans. After all, in the "early days," nobody knew anything about heart scans. It was a long, hard climb against ignorance, habit, entrenched thinking, stubbornness, and stupidity. I've been paid next to nothing for all this. I told Steve long ago that, given the extraordinary expenses of maintaining an independent scanning center, that he should first pay his expenses, pay his technologists, receptionists, and nurse, pay himself, then pay me for reading scans if he had any money left over. Most of the time, Steve had nothing left over and I was paid nothing.

So, while some of my colleagues were assuming that I was rolling in money from "promoting" heart scans, the reality was that I was doing nearly everything for free. (It certainly wasn't the high life I was living; I don't drive a Mercedes, take fancy vacations, none of that. In fact, I work about 51 weeks a year.)

Why do I do this if it doesn't yield a big flow of money? Because I believe in it as a superior path to the conventional. If I were simply interested in making more money--I wouldn't do it. I would simply do what all my cardiology colleagues are doing: more heart catheterizations, more angioplasties and stents, learning how to do carotid stents, iliac stents, peripheral angioplasty, renal stents, acquiring the skills to put in defibrillators, new device insertion like umbrellas in the interatrial septum, etc. There's plenty more money in that. It's also not that hard. I know, because that is my background: high-risk cardiac interventions. That's what I was trained to do, that's what I did from a number years, until I started to see that this was nothing more than "putting out fires" in people who became increasingly ill and reliant on bail-out procedures. It makes lots of money, but it is also fundamentally wrong.

So, no, I do not sell heart scans, nor is the Track Your Plaque program or The Heart Scan Blog meant to promote heart scans except as a tool for tracking this disease.

That's it, pure and simple.

Comments (12) -

  • Anonymous

    7/18/2008 2:10:00 PM |

    Kudos to your Dr.Davis!

    I've been reading your blog for some months and recommending it to others.

    Maybe you should make this entry a link from the main page so it is always available.

    It's obvious to me that you're not doing this to sell something. However, perhaps to some who make a judgement in a snap, this may not be immediately apparent. There's cynicism in general about Dr. motivations, some deserved due to the influence of drug companies, device manufacturers and their consulting arrangements. It's unfortunate that the good Docs get associated with this too.

    IMHO - You're very credible based upon your clinical experience and results. Knowing that there is not a big financial alterior motive adds to that and helps broaden the audience who can benefit from your contributions.

    Thanks again Smile
    (36 years old, heartscan score: zero, believer in prevention)

  • Neelesh

    7/18/2008 2:28:00 PM |

    Dr Davis, I hope you are not too irked by those comments. Whoever has made such remarks about you  is either clueless or is threatened that they cannot do stents, unnecessary CT angiograms and bypass surgeries if too many people become aware of your efforts. As far as we are concerned, you have given hope for all of us, while "others" were preparing the table for a next event.

  • mike V

    7/18/2008 3:03:00 PM |

    Dear Dr Davis:
    Thank you for what was clearly an emotionally driven and thoroughly convincing statement of your core principles.

    Now how about a few more of your cardio colleagues with sufficient principles (and cajones) to stand up there with you?
    OK, where are you all? Stand up please!

    What I truly appreciate is the informal preventive feedback you derive for us from your patients, even though I am personally fortunate to have no detectable heart disease.
    In all sincerity,

    mike V
    (older than John MCain!)

  • TwinB

    7/18/2008 5:42:00 PM |

    You dealt with that attack well Dr. D. I want you to know that I've been reading your blog for 6 months and I'm impressed by the quality and variety of information you provide. As a CAD patient who's been treated and operated on with the conventional techniques, I decided to pay for a Vit. D test and the VAP, just to see...

    My "D" level was 16 - severely deficient, and the VAP results were horrible. I have a call in to my internist but I doubt he'll do any more than shrug his shoulders. He once said he was "not into the minutiae of lipid testing".

    Thanks to your book and blog, I can begin to address my test results and overcome this terrible disease. Keep up the good work. You must be doing something right if the attacks are coming. hehe.

  • Zbigniew

    7/18/2008 7:03:00 PM |

    I have found your blog a while ago and thanks, doc, it's you who you drew my attention to things I had neglected (vit D, niacin, e.g.).
    By the way, I wouldn't see anything indecent if you WERE placing commercials of medicines and services, provided it's clear that's a commercial in this corner and not something smuggled between lines.

  • Anonymous

    7/18/2008 7:54:00 PM |

    When I first landed on this site, similar thoughts went through my mind. I can't say I blame newcomers for being skeptical with the level of scam artists and pseudoscientific websites out there, but after doing some digging, I quickly realized your message was credible, genuine, and invaluable. You've got my respect.

  • Dr. William Davis

    7/18/2008 11:22:00 PM |

    Thanks kindly, all, for the votes of confidence.

  • Jessica

    7/19/2008 3:49:00 AM |

    And thank God there are doctors like you out there. Doctors who are doing things because they're the right things to do, not because their office needs lunch a couple of days a week or because they need to finance their wife's new car.

    I'm confident there are more supporters out there than doubters and I'm very thankful I found your site. As a fellow promoter of health, it's great to have you on our side. We need more like you!

    Thanks for all you do. It's very much appreciated!

  • moblogs

    7/19/2008 10:17:00 AM |

    It's easy to see that you care about what you believe in, so no explanation was really needed. Smile

    I've followed your blog for a few months now. Not out of having any heart troubles, but out of interest in vitamin D discussion.

  • HenryC

    7/19/2008 4:35:00 PM |

    Dr. Davis,

    Thanks for clearing that up. In my experience with different doctors it seems that they care what they can get out of it instead of what is best for the patient. It is hard to find someone who really cares about the patient than their own pocket.

    I have reading your blogs for a while. I have not seen you selling any services or products.

    Thanks for being honest.

  • virginia

    7/19/2008 9:46:00 PM |

    I'm impressed with your "formula", check in once/week (for at least a year, now), have incorporated many of your suggestions EXCEPT the heart scan. I cannot reach the Orlando scan center that is listed as a participant, and made the decision to have it done even after my primary (whom I hold in the highest regard, and who sent me to a cardiologist because she thinks "something" is going on) scoffed at its efficacy. If you could address, in your blog, the specific test to request at a standard radiology center, I would appreciate it.

    ps.After Tim Russert collapsed and died, I immediately went to your blog, and followed your comments.  pps. my brother, age 51 with an occluded artery, printed out your info and politely asked his cardiologists to read it.

  • Carrie Tucker

    9/16/2008 8:05:00 PM |

    I can't believe anyone accused you of alterior motive.  They have obviously not read much of what you write.

    My question is, do you get a cold shoulder and maybe even threats from the cardiology community?  

    Thanks for fighting this battle for us.  You are my hero!