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#1 A growing trend in the United States is doctors doing unnecessary vascular procedures on unsuspecting patients. These procedures include ballooning, stenting, and even lasering harmless plaques in leg arteries.

#2 The event reminded me that health screening can be a powerful tool to detect disease and prevent tragedy, but it can also be a business model to recruit patients for treatments they don't need.

#3 The practice of doing unnecessary procedures on leg vessels is widespread in the medical community. I had become aware of this through conversations I'd had with my friend Jim Black, the chief of vascular surgery at Hopkins.

#4 Doctors are very good at nudging patients, and they know the words that will get their attention. For example, if an orthopedic surgeon is helping a patient decide between a knee replacement and a nonsurgical option, he may mention the joint is bone on bone.