Blowup at Milwaukee Heart Scan

A local TV investigative news report just ran a critical report of the goings-on at Milwaukee Heart Scan:

Andy Smith went to Milwaukee Heart Scan. "It passed the smell test like a road kill skunk. I mean it was bad," Smith explained.

Our hidden cameras went inside the high pressure sales pitch. "On a good day I sell eight, nine, 10 people. On a bad day probably three," sales manager Angelo Callegari told us.

What the heck happened?

Let me tell you a story.

Back in 1996, I learned of a new technology called UltraFast CT scanning, or electron-beam tomography (EBT), a variation on the standard CT technology that permitted very rapid scanning, sufficiently rapid to allow visualization of the coronary arteries. Back then, only a few dozen devices had been established nationwide.

But the technology was so promising and the initial data so powerful that I lobbied several hospital systems in town to consider purchasing one of the $1.8 million devices. I was interested in applying this exciting technology for early detection of coronary heart disease in Milwaukee. While administrators from several hospitals listened, they quickly lost interest when they figured out that the scanner was primarily a tool for prevention, and would not be directly useful to increase revenue-generating hospital procedures.

I floundered about for a year, trying to drum up support for obtaining a scanner. The manufacturer of the device, Imatron, put me in touch with a couple from Indiana who were also interested in setting up a scanner and had actually obtained the investment capital to do it. We met and, over the next year, got Milwaukee Heart Scan up and running. I served as Medical Director (but never an investor or owner).

Milwaukee Heart Scan was busy from day one, performing EBT heart scans, as well as CT coronary angiograms as long ago as the late 1990s, virtual colonoscopies, and other imaging tests. We all spent a great deal of time educating the public and physicians on what this technology meant for detection and prevention of disease.

Despite the public's perception that the owners, Nancy and Steve Burlingame, were making a bundle of money, in reality they could barely pay their expenses. As price competition heated up in Milwaukee with the lower-cost competing multidetector scanners cropping up, the Burlingames often did not pay themselves.

My interest was to keep this device afloat. I therefore told the Burlingames that they should pay their bills first--their staff, overhead, the scanner costs, and pay themselves--and not worry about reimbursing me for the (very modest) heart scan interpretation fees. For several years, I read thousands of scans without any compensation. But that was okay with me--I just wanted to be sure this device remained available.

But in 2008, some business people from Chicago contacted Steve Burlingame with prospects of applying a contract model of long-term scanning to patients,i.e.,getting people to sign a several-year contract for discounted imaging. They proposed that Milwaukee Heart Scan offer heart scans for free to get people in the door.

What was peculiar about all this is that none of the four physicians on staff at Milwaukee Heart Scan had any knowledge of these discussions at all, including myself. Personally, I figured something was afoot when I came in to read scans in the summer of 2008. While, ordinarily, there is a single stack of scans to read from the preceding few days, this time there were numerous stacks of scans, hundreds of scans in all. Not a word had been said to me or my colleagues. I quickly figured out (thanks to the staff filling me in) that they had been offering scans for free. Not surprisingly, many people took them up on the offer.

Up until then, I had been readily willing to read heart scans without compensation, provided I could perform scan readings in a modest time commitment every week on the weeks it was my responsibility. But work several hours every day for free? Impossible.

My colleagues and I were deeply upset and concerned and insisted on a meeting with all the people involved, including the Burlingames, who had engineered this new sales program. We expressed serious reservations about what they were doing and insisted that they dramatically scale back the promises being made to people. I personally asked that they fire several of the people they had hired as sales people, given what we thought was unprofessional appearance and behavior.

The Burlingames and their new business partners essentially thumbed their noses at the physicians and ignored our advice. So, of the four physicians (one radiologist, three cardiologists), three of us resigned. (The one remaining cardiologist, I believe, didn't really understand what was going on.)

Apparently, after we left, the hard sales tactics continued. The news media got hold of the story through some understandably disgruntled people, and you know the rest.

The tragedy in all this is that, as wonderful as heart scans are, they don't make money for the people who invest in the technology. In the sad case of Milwaukee Heart Scan, it meant that my former friends, the Burlingames, turned to questionable tactics to make this technology pay.

Make no mistake: Heart scans remain a wonderful medical imaging modality. EBT, in particular, remains a fabulous technology that would--even today--remain the pre-eminent means to image coronary arteries, except that GE (who acquired Imatron some years ago) decided that a more direct path to bigger revenues was to purchase Imatron, then promptly scrap the entire operation, choosing to focus on multidetector technology exclusively.

Don't let the spotty past and petty ambitions cloud the fact that heart scans remain the best way to identify and track coronary plaque. Just don't get tempted by the offer of any free scans "without obligation."

Comments (20) -

  • mbyrnes1

    3/26/2009 2:09:00 AM |

    Would this compromise the interpreted results of a recent heart scan from Milwaukee Heart Scan?

  • steve

    3/26/2009 3:05:00 PM |

    why isn't carotid artery imt study augmented by NMR Lipoprotein study good enough?

  • Dr. William Davis

    3/26/2009 9:41:00 PM |


    No, it should not, though I cannot vouch for the quality of readings that occurred after we left last year.

  • Anne

    3/26/2009 11:00:00 PM |

    You need to update your profile on the "Meet our Experts" page in Track Your Plaque website. It still says that you are the Medical Director of Milwaukee Heart Scan.

    Thank you for the updated information.

  • karl

    3/27/2009 1:01:00 AM |

    I just got an appointment in Wichita for a $10 heart scan.  Wonder what the pitch will be?


  • Dr. William Davis

    3/27/2009 1:11:00 AM |


    Thanks for catching that, Anne.

  • Rick

    3/27/2009 1:34:00 AM |

    After finishing reading Track Your Plaque recently, and noting the date of publication, I had assumed that EBT was now available everywhere in the States and that probably there were even better imaging technologies available now. But are you saying the technology has just been scrapped? That's a tragedy.

    I don't know enough about Milwaukee Heart Scan to comment on the specifics, but as a general idea doesn't it make sense, where the existing medical/insurance system isn't meeting people's needs, to come up with a subscription service where people get, say, a scan a year for five years, so that they can monitor their progress? Of course, they need to be given a chance to find out the total costs involved in anything they sign up for.

  • Dr. William Davis

    3/27/2009 1:02:00 PM |

    Hi, Rick--

    Actually, I think the Milwaukee Heart Scan people hit on a useful idea, that of subscription discounted imaging services. However, I disagreed with the way they went about it.

    Perhaps someone else will be able to construct a program that is honest and truly an advantage to subscribers.

    Those of us who were originally involved in the EBT technology lost many nights of sleep when GE unexpectedly scrapped this technology for no reason other than financial advantage. They didn't have to buy Imatron; they just could have let them continue while competing against them in their own arena. But, no, they wanted to clear the path. Very, very bad policy on the part of GE. Yet another example of excessive corporate greed that has plagued American business over the past few years.

  • Jonathan

    3/29/2009 1:27:00 AM |

    If the existing EBT scanners go out of service, will there be any alternative?

  • Stan (Heretic)

    4/4/2009 2:02:00 PM |

    Sorry to hear about the business problem.

    To amortize the machine at 6% all you needed to do is take only 2 patients a day charging 200$.  With 4 doctors and two people - the original investors available for work, I presume, you could probably take ten times as many patients, working out a decent profit for all of you.  I am curious why it did not happen, what has gone wrong?

    Did GE default on service and warranty? That would certainly kill the biz.  

    Why hiring a push saleseman if a good advertising campaign in the greater Chicago area of ~10 million people, might probably suffice?

    Why as you said, did it take long to process each scan, I thought that the machine itself would just spew out a number:  Agatson's Calcium Score which a patient would then use him/herself to tweak their own therapy using your published guidelines, periodically retesting their ACS at let's say 200$ per visit, with or without a doctor's consult.  

  • Stan (Heretic)

    4/4/2009 2:15:00 PM |

    Dr. Davis wrote: But, no, they wanted to clear the path. Very, very bad policy on the part of GE. Yet another example of excessive corporate greed that has plagued American business over the past few years.

    I disagree, this was a prime example of corporate incompetence destroying their own business!  If they were truly greedy and wanted to make money they would be still selling this technology.  As it happens GE is a glamorous corporate shell that owns thousands of derelict rusted factory building all over the North America, that they bought years ago but never invested in.  One is near the place where I live, I see their ruin almost everyday each time I drive by.

    I use the knowledge of their true condition, to short this corporate loser on the stock market periodically, to profit out of their decline. People like me do the society a favor by helping eliminate the corporate waste like you the plaque.  8-)

    Dr. Davis, there is nothing wrong in making money through own your honest work and creative skills.  You deserve your pay and a greed like that is good!


  • Quazimoto

    3/24/2010 5:31:28 PM |

    where do you recommend getting a heart scan in Milwaukee?

  • Anonymous

    4/27/2010 4:58:39 AM |

    haven't they reclassed the radiation those things put out ?
    I suppose if you are dying then the risk is worth it.

  • Mike C

    7/9/2010 1:51:12 PM |

    Vital Imaging, LLC is now performing EBCT heart scans. Located at 10500 W. Loomis RD. (414) 774-7600  We are in the busines of early cornary artery disease detection. $199 with no strings attached. 5 to 10 times less radiation than conventional multi-detector CT scanners and much faster with higher resolution for organs that never stop moving

  • buy jeans

    11/3/2010 4:56:10 PM |

    But in 2008, some business people from Chicago contacted Steve Burlingame with prospects of applying a contract model of long-term scanning to patients,i.e.,getting people to sign a several-year contract for discounted imaging. They proposed that Milwaukee Heart Scan offer heart scans for free to get people in the door.

  • Anonymous

    11/9/2010 12:11:02 AM |

    i am one of the unsuspecting idiots who signed the contract and now do not get what i paid for and am still paying for......unfortunately i do know that i am not alone-that is the suckiest part!

  • Anonymous

    1/14/2011 5:06:20 PM |

    We also got suckered into a 3 year long contract.  We finally decided to go for it when a friend of mine who is a nurse said she had worked with and really respected some of the doctors who were reading the scans.  Unfortunately for us, even the doctors were unaware of what was going on at Milwaukee Heart Scan.

  • Andy Teske

    6/1/2011 1:43:03 AM |

    Dr. Davis,

    Do you have any opinion on Vital Imaging, LLC?
    I was a patient at Milwaukee Heartscan before their downfall and am looking for a 5 year update heartscan.  Should I go to Vital Imaging for the EBT, or use one of the many new CT providers?  Thanks!

  • Richard Blake

    10/17/2011 9:51:07 PM |

    I signed a contract with Heartcheck America in the summer of 2010. My contract included one virtual colonscopy and granted me the right to assign any of my ten annual full body scans to any relative or acquaintance. That made the deal worthwhile to me, as I had no interest in a scan that often. By the next summer they were gone. But from what I've read they did not go out of business. They were put out of business by lawsuites from states including Colorado. From what I understand, those suits complained that a potentially dangerous medical procedure was being performed without being ordered by a physician ...  and besides, the results were not all that useful ... and also some people complained that they had been pressured into signing expensive contracts. I don't want my money back, I want what I signed for and paid for, but I'm not going to get it. Thank you, Colorado.

  • Susan Talaska-Pikalek

    2/2/2012 5:42:44 PM |

    So who is taking over the contracts from Milwaukee heart scan?

Heart scan curiosities 3

Heart scan curiosities 3

This is a sample image from the heart scan of a 54-year old, 212 lb, 5 ft 2 inch woman. The heart is the whitish-gray in the center; lungs are the dark (air-filled) areas on either side of the heart. Note the massive amount of surrounding gray tissues that encircles the heart and lungs. This is fat. At this weight, the diameter of total fat exceeds the combined diameter of the heart and lungs. If we were to show the abdomen, there would be even more fat. (The image shows the body not well centered because the technologist centers the heart, since this is, after all, a heart scan.)

This is a 55-year old, 151 lb, 5 ft 4 inch woman. Note the contrast in the quantity of fat tissue surrounding the chest, a much more normal appearance. Note that this woman is still around 25 lb over ideal weight, but not to the extreme degree of the woman above.

Another curious observation: Note the more whitish streaking in the heavier woman's lungs. Heart scans are performed while holding a deep inspiration (a deep breath inwards), mostly to eliminate lung respiratory motion during image acquisition. Nonetheless, the heavier woman's lungs are not as fully expanded as the more slender woman. In other words, the heavier woman cannot inflate her lungs as effectively as the thinner woman. Ever notice how breathless heavy people are? Some of this effect is just being out of shape. But there's also the added effect of the abdominal fat exerting upwards compression on the lung tissues, and the constrictive effect of the encircling fat mass. At the beginning of inspiration, the chest fat exerts the resistance of inertia to inspiration that is absent, or less, in a slender person. With each breath, the heavy woman must move 50 lbs or so of surrounding fat mass just to inhale.

The heavier woman is, in effect, suffocating herself in fat.

The distortions to the human body incurred by extreme weight gain are both fascinating and shocking. I hope you're breathing easily.

Comments (7) -

  • Anonymous

    12/14/2006 4:55:00 PM |

    Exactly what triggers people to choose to be obese or even 20 lbs overweight? I find it disgusting.  People have to realize being overweight is unhealthly and puts that person at extreme risk for health problems. How sad it must be for young children not to have parents that can run with them in the park or worse yet lose one to heart disease, stroke or cancer.

  • Soundhunter

    1/1/2007 7:04:00 AM |

    hmmm. Me again, commenting twice.

    My 5 month old daughter has "pectus excavatum ", the docs said it's mild and won't show when she's an adult, they only seemed concerned with it for cosmetic reasons.

    I also have thought that the roof of her mouth seemed "deeper" or higher I guess you could say, than my other daughter's was in infancy. But, 5 monther with pectus excavatum doesn't have slender fingers, though she is quite long, repeated ultrasounds showed she had long legs. Is she possibly at higher risk for heart problems as an adult? Why wouldn't 2 different family docs know this, or tell me about it?

  • Dr. Davis

    1/1/2007 2:30:00 PM |

    An ultrasound of the heart, or echocardiogram, would settle the question. It's a harmless test that requires just a few minutes. If your daughter's doctor won't order it, find one that will.

  • Mo D.

    2/27/2007 2:54:00 AM |

    I'm saddened but not surprised that a doctor would call pectus excavatum just a curiosity.  I have quite a number of heart and lung ailments from my PE.  Had my doctor felt differently about PE when I was a kid and had suggested surgery, I would have suffered less than I have to having the surgery in my 30s. They say the teen years are the best time for surgical repair of PE. So yes, PE does cause heart and lung problems in adults.  At least this adult.

  • Anonymous

    2/28/2007 3:55:00 PM |

    Here's a relevant cite:
    Cardiovascular function following surgical repair of pectus excavatum: a metaanalysis.

  • Paul Höppener MD Phd

    11/16/2007 6:32:00 PM |

    I am a 69 year old retired fysician.With a moderate congenital pectus excavatum. For more than 10 years I suffered from complaints like shorness of breath, fatigue and arythmia.Even a catheter ablation has been performed 4 years ago to stop Supraventricular tachycardia of 220.min. After 3 months a more moderate tachycardia returned. My complaints where posture dependent: bending or pressure on the upper abdomen or the pectus cavity did increase the problems.
    CT showed cardiocompression!
    To go short: after corrective surgery (Ravitch) my complaints have totally disappeared. I could stop with all medicines, can walk uphill agian and cycle with proper speed. Reborn without reincarnation.
    Lesson: symptomatic pectus excavatum can also happen to senior people an dcorrective surgery is worth while.
    See also:

  • buy jeans

    11/3/2010 2:54:30 PM |

    It could mean that some attention and exploration of how floppy his mitral valve might be could be useful, e.g., an ultrasound or echocardiogram. He might even require oral antibiotics at the time of any oral or some gastrointestinal procedures, since floppy valve are more susceptible to blood infections when potentially "dirty" orifices are instrumented.