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30 Comments
- AlanLivingston, on 12/11/2007, -1/+7First a disclaimer. My wife is a Nurse Practitioner in an Oncologist's practice.
I've heard her state that the re-reimbursement rates from insurance and medicare for some Chemo regimens are LESS than the cost of the chemo. What's the physician supposed to do?
And sometimes there are multiple regimens with no difference in outcome. What doctor wouldn't choose to maximize his profit. If you think medicine isn't a business, you're very naive.
Personally, I think this article is scaremongering and inaccurate. - kymike, on 12/11/2007, -1/+7Sorry, but I totally disagree. Many doctors are just as guilty as the insurance companies - like the article said, medicine is a business, and many doctors see it as nothing more than that.
Moreover, there are so many "bad" - or at least, not as good as they should be - doctors today. And most spend so little time with their patients.
My dad had a heart attack in 1994, and had to have a quad bypass. He had another couple of heart attacks in 2000, which put him in heart failure (ejection fracture 12%). He was extremely week and had lots of fluid buildup. He went to several doctors, all of whom wrote him off and didn't even try to think outside the box.
He finally found one great heart doctor, who examined him as an individual. He did thorough studies on his heart. He figured that not _all_ of the damaged heart tissue was completely dead, that if he could just increase blood profusion, it might restore some heart function. So he went with a stent, and sure enough, blood began pouring into the damaged areas of my dad's heart. Months later, he was much stronger. He's since had a second stent put in, and also a pacemaker / defibrillator, in order to help his enlarged heart function more efficiently. As a result, he is in much better shape now (ejection fracture around 24%), walks three miles each day, and can do pretty much anything he wants (he even mows the lawn with a push mower - he just takes his time).
All thanks to a single doctor that truly gave a damn. - kmusser, on 12/11/2007, -4/+10The problem is not with the doctors its with the insurance companies that pay less than the cost of the procedure for most things doctors do. I wouldn't be surprised if the markup people are seeing here is due to getting paid less for other procedures. While there are some bad doctors out there I really think a lot of articles make the public mad at the wrong people, doctors. When the real culprits are the insurance companies and pharmaceutical companies; they should be getting anger directed towards them.
- reddline, on 12/11/2007, -2/+8Great, so even if I get cancer I am still getting screwed by my Dr. How wonderful...
- RetroRufio, on 12/11/2007, -0/+4That picture is subtly frightening
- ngmcs8203, on 12/11/2007, -2/+5I had cancer. It was treated. And now I'm cured. By cured I expect you mean some sort of shot that would act like a vaccine? That'd be a ***** of shots considering how many different kinds of cancer there are.
- guyincognitoo, on 12/11/2007, -0/+2The kids are on all of those pills because that is what the parents want. They think that if their kid is not perfect, there is something wrong with them and they need pills. The Doctors have to relay on the parents telling them how the kid behaves during the day, so that is all they have to go on. They can't be with the kids 24/7 to see what he is doing.
- jpend, on 12/11/2007, -2/+4Oncology is only one area that this happens in. Take diagnostic imaging (MRI & CT) where there are many instances where physicians own centers or have "agreements" with operators to get a cut. Federal laws have tried to stop it, but those with creative attorneys have found ways to profit from each patient's testing. Best way to know?....ask if they have a financial relationship with the provider you are being sent to. Some states require they tell you.
- Shaman760, on 12/11/2007, -2/+4Why do you think the current crop of teenagers are playing out their Duke Nukem scenarios in shopping malls? Paxil, Prozac, all those SSRI drugs are being "abused" by doctors in the name of getting that big kickback check at the end of the day.
- JusticeAK, on 12/12/2007, -0/+2Cancer is a HUGE business.
- maffiou, on 12/11/2007, -3/+5Well, as a cancer survivor myself, I beg to differ... Please don't spread misinformation like that...
I think you should question the medical system in the USA, rather than the technology. I lived in France when I received my treatment, It definitely saved my life, without my paying a penny (Not exactly as I was a taxpayer there)...
Medecine is in a sad state in the US... - darthom, on 12/11/2007, -1/+3You must be a doc or planning to be one or perhaps you are just being naive. Like the article states, they go where the money is, regardless the source.
- ProfessorBunny, on 12/11/2007, -0/+2Good point. Thank you for a positive perspective on the issue. As you might have noticed, I'm still a bit raw from my past experiences. I'm very glad to hear things have worked out well for you. Congratulations!
- stonebear, on 12/11/2007, -0/+1Get it straight from the horse's mouth: One man's personal experience with this.
Jerry Brunetti - Food As Medicine
http://video.google.com/videoplay?docid=-884123432 ...
http://video.google.com/videoplay?docid=-779811715 ... - kmusser, on 12/12/2007, -0/+1While I'll agree that many do think of it as a business (because thats how the view is here in the states); thats not the way it should be. One shouldn't want the patient to be sick, the goal should be to keep the patient out of the hospital because they are healthy.
In addition, the reason many doctors don't spend much time with their patients is due to HMOs paying per patient. If a GP wants to be able to support his family as well as pay off a quarter million dollars worth of loans (or more) then he has to spend less time with many patients. This is of course heartbreaking because many doctors would LOVE to spend more time with their patients. Unfortunately, this is the path that HMOs and the big business of health insurance has paved for patients and physicians.
In my humble opinion, someone that is going into medicine for the money is going into the wrong profession. It might have been that way many years ago but the fact of the matter is that many new doctors going into the field today (should) be going into it for the patients and the science; doctors get very little of the prestige and money they used to. - stonebear, on 12/11/2007, -0/+1Corrected links:
http://tinyurl.com/2d239g
http://tinyurl.com/2h6spv - john570, on 12/11/2007, -0/+1And this is surprising how???
- mjw2025, on 12/11/2007, -0/+1So am but I have a question. When you were diagnosed were you able to choose your doctor?
- Ascus, on 12/11/2007, -0/+1The problem is that the patient is not informed of the business connection. The fact they get a commission is not a problem.
- slowth, on 12/11/2007, -0/+1Surgery is still the first option for most solid tumors, although adjuvant chemotherapy is occasionally used with surgery depending on the particular patient and situation. If the cancer is caught early enough, then many patients will never receive chemotherapy. For other cancers, like lymphoma and leukemia, there really isn't a tumor to remove surgically so the initial treatment is chemotherapy, which is extremely effective (70-80% cure rate). I agree with your point about hospice care, but put yourself in the doctor's shoes. If you don't aggressively treat the cancer with every possible treatment option until the very end of the patient's life, then you are at the mercy of the lawyers. Yes, chemotherapy is minimally effective in treating advanced, metastatic cancer. As long as the patient and their family knows are completely aware of this minimal efficacy, then there should be no problem. Ultimately, the patient and their family decides on treatment. They can refuse treatment at any time. I also agree with your point about pain management. This is a serious issue and change appears to be on the way.
- DrDigg, on 12/12/2007, -0/+1SInce the FDA put warnings on using those drugs in children teen suicide has skyrocketed. PS the most any doctor gets for prescribing SSRIs is a pen or free lunch. Hardly a kickback.
- bremstrong, on 12/11/2007, -0/+1You need to be pretty cynical not to be surprised by this.
Wouldn't it be nicer not to have doctors that patients trust giving them drugs that are simultaneously: expensive, ineffective, and have painful and dangerous side effects?
Because that's what having 75% of your income directly resulting from prescribing chemotherapy drugs will do to you, as a trusted physician.
The system needs a simple adjustment, obviously: sell chemotherapy agents without a kickback to the prescribing physician, like all other drugs. - guyincognitoo, on 12/11/2007, -0/+1Medicare and Medicaid don't pay *****. You will be lucky to get $20 or $30 from them for the patient, if anything at all.
- AlanLivingston, on 12/12/2007, -0/+1Does your mechanic inform you that he makes money on the parts that he uses when he fixes your car? Is it a "problem" if he doesn't? Of course not!
Medicine is a business, like it or not. Take away all the profit and there will probably still be a few doctors practicing but a lot of people aren't going to have access to health care anymore. - AlanLivingston, on 12/12/2007, -0/+1You know... I think you're right.
Now, since the physician needs to make up that profit somewhere, guess where it's going to come from? Office visits. He'll no longer participate in insurance plans, since they negotiate the fees he can charge. Now you're paying out of pocket for the difference between what your insurance covers and what he charges -- assuming you can even see a physician that doesn't participate in your insurance plan.
Yes, you're idea sounds SO much better. - Carpussle, on 12/11/2007, -1/+1I urge EVERYONE to research Coley's Toxins
- onemoney, on 12/11/2007, -2/+1The amount BlueCross and other insurance companies reimburse for office visits, routine lab tests, diagnostic procedures, surgery, and other treatments for cancer care is atrociously low. Doctors deserve to make lots of money. The drug reimbursement (pre-2005) was one way for them to do it. Now the government is taking even that money away. The problem is we need quality health care but would rather spend our money on plasma screen tv's and iphones.
- GRANDPAMUNSTER, on 06/11/2009, -5/+4Does anyone really believe that there will ever be a cure for cancer, while drug companies can make billions by just treating cancer, not curing it.
- mjw2025, on 12/11/2007, -2/+0If medicine wasn't a business they wouldn't exist.
- ProfessorBunny, on 12/11/2007, -8/+3Having lost 3 friends to Cancer in the last 10 years, I have to say that chemotherapy is not a viable answer for most cancer patients. Unless your specific type of cancer is receptive or they catch it in the earliest of stages all "chemo" does is prolong your suffering. It seems most hospitals and physicians are more interested in keeping you alive long enough to drain you and your family of every last dollar. It's really very sickening. Your best bet when you have a virulent form of cancer is to go home and hire Hospice workers (which many times are a free or very affordable alternative) to come and make sure your medicated for pain (something the hospitals will not offer in lieu of quack remedies and flooding your already necrotic tissues with radiation)
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