not what the doctor ordered

Report: Houston ranks among the worst cities for unnecessary medical treatments

Houston hospitals have been reported to have an excess of unnecessary health care tests and procedures. Photo by Dwight C. Andrews/Greater Houston Convention and Visitors Bureau

Houston boasts of being home to the Texas Medical Center, the world's biggest medical complex. Yet Houston's medical community also holds a distinction that's hardly boast-worthy: It's the worst major metro area in Texas for unnecessary health care tests and procedures.

A study released May 4 by the Lown Institute, a health care think tank, shows hospitals in the Houston area collectively fare worse than their counterparts in Dallas-Fort Worth, San Antonio, and Austin for overuse of tests and procedures that the institute says offer little to no benefit.

To come up with its ranking, the institute looked at Medicare data for more than 1 million tests and procedures performed at over 3,100 U.S. hospitals from 2016 to 2018. Among the overused tests and procedures identified in the study are hysterectomy for benign disease, placement of coronary stents for stable heart disease, and diagnostic tests like head imaging for fainting.

"Overuse in American hospitals is a pervasive problem that needs to be addressed," Dr. Vikas Saini, president of the Lown Institute, says in a news release. "Hospitals want to do better, and these objective measures of performance can help them move forward."

Hospitals in Texas ranked fourth worst among all the states for overuse of hospital tests and procedures, the institute says.

Among hospitals in the Houston area, Houston Methodist Sugar Land Hospital ranked worst for overuse of tests and procedures, preceded by Memorial Hermann Northeast Hospital in Humble, OakBend Medical Center in Richmond, Memorial Hermann Sugar Land Hospital, and St. Luke's Health - The Woodlands Hospital, the study says.

At the other end of the spectrum, Houston's Doctors Hospital Tidwell ranks first among Houston-area hospitals for avoiding overuse of tests and procedures, followed by the University of Texas Medical Branch at Galveston, Memorial Hermann-Texas Medical Center, Harris Health System, and HCA Houston Healthcare Clear Lake in Webster.

Estimates suggest that overuse of tests and procedures contributes $75.7 billion to $101.2 billion to wasted U.S. health care spending each year, according to a study published by the journal JAMA Open Health.

"Although clinicians are responsible for ordering tests and treatments, their practice patterns may be influenced by hospital policies and culture. Hospital-level interventions to reduce overuse exist, but to measure and compare their success, a hospital-level measure is required," the study says.

In 2017, a study appearing in the Journal of Hospital Medicine declared that overuse of medical services contributes to low-quality health care and high health care costs. It's estimated that 42 percent of Medicare patients, 15 percent of Medicaid patients, and 11 percent of traditionally insured patients are subjected to at least one overuse of medical services each year, according to an article published by the Journal of Health Affairs.

"We can leverage the circumstances created by the pandemic to advance our understanding of low-value care with the goal of better measurement, appreciation of its harms, and a deeper understanding of its drivers and determinants, so that interventions can be implemented," authors of the Journal of Health Affairs article wrote. "Low-value care harms patients; there has never been a better time to push toward eliminating hurtful practices."

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Building Houston

 
 

Kelly Avant, investment associate at Houston-based Mercury Fund, shares how and why she made her way into the venture capital arena. Photo courtesy of Mercury

Kelly Avant didn't exactly pave a linear career path for herself. After majoring in gender studies, volunteering in the Peace Corps, and even attending law school — she identified a way to make a bigger impact: venture capital.

"VC is an awesome way to shape the future in a more positive way because you literally get to wire money to the most innovative thinkers, who are building solutions to the world’s problems," Avant tells InnovationMap.

Avant joined the Mercury Fund team last year as an MBA associate before joining full time as investment associate. Now, after completing her MBA from Rice University this month, Avant tells InnovationMap why she's excited about this new career in investment in a Q&A.

InnovationMap: From law school and the peace corps, what drew you to start a career in the VC world?

Kelly Avant: I graduated from Rice University with an MBA, starting scouting for an investment firm in my first year, and by the summer after my first year I was essentially working full-time interning with Mercury. But, I like to tell people about my undergraduate degree in gender studies and rhetoric from a little ski college in Colorado. If you meet someone else in venture capital with a degree in gender studies, please connect us, but I think I might be the only one. I’ll spare you what I used to think — and say — about business students, but I have really come full circle.

I always thought I would work in a nonprofit space, but after serving in Cambodia with the Peace Corps, working for the National Domestic Violence Hotline, and briefly attending Emory Law School with the intention of becoming a civil rights lawyer.I found that time and time again the root of the problem was a lack of resources. The world’s problems were not going to be solved with my idealism alone.

The problem with operating as a nonprofit in a capitalism is you basically always pandering to the interests of the donors. The NFL was a key sponsor of The National Domestic Violence Hotline. The United States has a complicated, to put it lightly, relationship with Cambodia and Vietnam. It became pretty clear that the donor/nonprofit relationship was oftentimes putting the wrong party in the driver’s seat. I was, and still am, very interested in alternative financing for nonprofits. I became convinced that the most exciting businesses were building solutions to the world’s problems while also turning a profit, which allows them to survive to have a sustainable positive impact.

VC is an awesome way to shape the future in a more positive way because you literally get to wire money to the most innovative thinkers, who are building solutions to the world’s problems.

IM: What are some companies you’re excited about?

KA: There are a couple super interesting founders I’ve met directly engaging with . To name a few: CiviTech, DonateStock, and Polco.

I’m very proud to work on mercury investments like Houston’s own, Topl, which has built an extremely lightweight and energy efficient Blockchain that enables tracking of ethical supply chains from the initial interaction.
I’m also excited about mercury’s investment in Zirtue, which enables relationship based peer to peer lending to solve the massive problem of predatory payday loans.

We have so many awesome founders in our portfolio. The best part about working in VC is meeting passionate innovators every day. I get excited to go to work everyday and help them to build better solutions.

IM: Why are you so passionate about bringing diversity and inclusion into Mercury?

KA: I love working with exciting, highly capable, super smart people. That category includes so many people who have been historically excluded. As an investment team member at Mercury, I do have a voice, and I have an obligation to use that voice to speak highly of the best people in rooms of influence.

IM: With your new role, what are you most focused on?

KA: In my new role, I am identifying and researching high potential investments. We’re building out a Mercury educational series to lift the veil of VC. We want to facilitate a series that gives all founders the basic skills to pass VC due diligence and have the opportunity to build the next innovative companies. My goal is ultimately to produce the best returns possible for our investors, and we can’t accomplish that goal unless we’re building out resources to meet the best founders and help them grow.

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This conversation has been edited for brevity and clarity.

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