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Financial Conflicts of Interest

Swingshiftworker
Posts: 656
Joined: Mar 2010

Here's an interesting article that I found about the financial conflicts of interest that may cause doctors to over "prescribe" IMRT and HT for PCa patients:

http://www.bloomberg.com/news/2012-11-06/prostate-patients-suffer-as-money-overwhelms-optimal-therapy.html

It is commonly reported (here and elsewhere) that urologists routinely recommend surgery for treatment of PCa, even though other potentially less damaging radiation treatments are available.

This article indicates that there are some doctors who recommend radiation (specifically IMRT) and hormone treatment (like lupron) over surgery and other less expensive treatments because of the financial incentives to do so.

Just goes to prove that you should ALWAYS get a 2nd opinion about any medical condition before you are treated and to specifically ask (or find out) if the doctor has a financial interest in the recommended treatment.

Caveat emptor!!!

caseyh
Posts: 63
Joined: May 2002

Dr. Michael Datolli, a radiologist who runs the Datolli Cancer Center in Sarasota, has written an interesting article that discusses the conflict of urologist owned radiation centers in his article, AMERICA: BEWARE OF THE URORAD.

http://www.dattoli.com/Dattoli_files/files/CHOICESvol27-2june2011.pdf

Well said Swing!

Caveat emptor!!!

laserlight's picture
laserlight
Posts: 165
Joined: May 2012

This does not come as a surprize. From what I have learned so far is that doctors tend to operate in their comfort zone. Being surgery, radation, and or chemo. This falls back to the person being diagnosed with PC. The second opinions really need to be looked at. I think that this should be part of the diagnosis process.

Swingshiftworker
Posts: 656
Joined: Mar 2010

The article speaks to financial corruption which leads to unethical conduct w/in the medical community -- not just recommending the treatment that you normally practice.

VascodaGama's picture
VascodaGama
Posts: 1592
Joined: Nov 2010

Back in 2010 I have posted in the forum on the news about this IMRT/Urologists affair. That was an article in the Wall Street Journal which was shocking commenting that IMRT was used in USA for the benefit of someone’s pocket, independently of patient need.

It says that: “…Roughly one in three Medicare beneficiaries diagnosed with prostate cancer today gets a sophisticated form of radiation therapy called IMRT. Eight years ago, virtually no patients received the treatment. The story behind the sharp rise in the use of IMRT—which stands for intensity-modulated radiation therapy—is about more than just the rapid adoption of a new medical technology. It's also about financial incentives.”

The full article can be seen here;
http://online.wsj.com/article/SB10001424052748703904804575631222900534954.html.html

I appreciate when we survivors pass the news to the newbies about biased doctors and institutions. The more we write the more awareness is taken. Thanks Swing for posting the article.

The article posted by Caseyh is very informative and I hope that it reaches the many in our boat. Thanks Casey.

Let’s hope that regulators strike hard on the authors of the “financial conflicts” pointed out above.

VGama

Swingshiftworker
Posts: 656
Joined: Mar 2010

Unfortunately, this means that this form of unethical conduct is really nothing new and ways to control it needs to be added to proposed "reforms" of Medicare in order to reduce/control costs.

This raises a question about how private carriers (vs. Medicare) are managing the reimbursement of IMRT and other radiation therapies for PCa. My CK treatment (which was billed out at around $70k) was paid w/o complaint by Blue Shield and my case didn't go to peer review to determine if a less expensive treatment (like surgery -- OMG!!) would be "good enough" instead.On the other hand, it's clear that NorCal Kaiser has already made a different judgment by refusing to offer CK when BT and Surgery "will do".

So, there apparently is wide variation in the management of the cost vs. effectiveness of PCa treatment.

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