Bait and switch

When banks compete, you win.”

The TV ad opens with a 60-something man sitting in his living room, talking to a three-piece suit-clad, 30-something banker. The older man is explaining to the dismayed younger man why he’s going to use Lending Tree loan service for a home loan.

“But Dad, I’m you’re son!” the younger whines.

Many of Lending Tree’s clients have collaborated in filing a multi-million dollar class action suit against the company, claiming “bait and switch” tactics. They claim that home buyers are lured by low interest rates or low closing costs on a home loan. Once the buyer concludes the hassle of filling out numerous forms, the suit accuses Lending Tree of making a switch to a costlier loan.

Bait and switch is among the oldest con games around. If you’ve ever bought a car from a car dealer, chances are you’ve had your own little brush with this deception. The ad promises the SUV you’ve wanted for only $299 per month. Only, once you get there, the salesman informs you that only a limited number of special deals were available and they’ve run out. But he’s still got a really good deal right over here!

Most of us recognize that we’ve been hookwinked. Yet we still go along and buy a car from the dealer.

What if it’s not a sleazy salesman behind the pitch, but a physician. If it’s hard to resist the sales pitch at the car dealership, it can be near impossible to ignore the advice of your doctor. But the truth is often loud and clear: in many instances, it is a genuine, bona fide, and fully-certified scam.

Among the most common bait-and-switch heart scams: Your cholesterol is high. The sequence of subsequent testing is well-rehearsed. “Gee, Bob, I’m worried about your risk for heart disease. Let’s schedule you for a nuclear stress test.” The stress test, like 20% or more of them, is “falsely positive,” meaning abnormal even though there’s nothing wrong with you. Another 30% are equivocal, not clearly abnormal but also not clearly normal. Now up to 50% of people tested “need” a heart catheterization in the hospital to clarify this frightening uncertainty. You might end up with a stent or two, even bypass surgery. Your simple $20 cholesterol panel has metamorphosed into $100,000 in hospital procedures. That familiar sequence is followed thousands of times, seven days a week, 365 days a year.

There are times when these heart tests are valuable and provide meaningful answers. Then there's the other half of the time when they provide murky information that can be used for a practitioner's economic advantage.

Copyright 2008 William Davis, MD

Comments (5) -

  • Anonymous

    3/24/2008 2:13:00 AM |

    My former doctor tried to catch me in this scam with everything he could think of including the "death and destruction card."  I continued to resist and got dropped as a patient.

  • Anonymous

    3/24/2008 10:33:00 AM |

    I used to have many gut issues when I was younger and remember suspecting a few doctors trying and probably even succeeding a few times to drum up business for money out of me.  One time in particular I remember saying no to a testing idea that a high strung doctor presented, she wanted to do a liver test that involved an operation.  She became upset with me when i said no, but I stood my ground and later found a better doctor for me to work with.  

    I think there is a chance I ran into a bait and switch heart doctor on the internet not that long ago.         Why many people place blind faith in health care providers isn't something I understand.

  • Anonymous

    9/19/2008 1:58:00 PM |

    Dr. Davis,
       What is the switch part of your scenario?  When a doctor says he is concerned, I presume it means I may have some disease that needs treatment.  Should doctors spend more time describing what positive and negative results mean?  Of course.  In advance of tests?  Of course. But it sounds like you are suggesting that tests be avoided, because treatment may follow.  Or did you mean that some doctors intend to give treatment regardless of test results? What's your point?

  • Anonymous

    4/5/2009 6:43:00 PM |

    I think the post means the test is the bait as in here have a test to see if you have a problem and the switch is an expensive, unnecessary surgery