Profit Versus Patient: A Sad Fact
As cancer patients, we have a lot to worry about. In this entry, I am going to climb out on a limb and discuss an issue that patients should never have to worry about - and one which I would never have raised had not Brian Williams addressed it on the NBC Nightly News last Thursday, September 21. His broadcast can be seen in its entirity at: http://media.vmsnews.com/MR.pl?id=092106-651798-G000760835
Brian and his colleage, Rehema Ellis, discuss a potential conflict in oncology which occurs because doctors can profit from the sale of drugs. Brian raises the question of whether patients get more drugs than they need or whether they get more expensive drugs than are necessary. Says Peter Eisenberg, a California oncologist, "A significant amount of our revenue comes from the profit that we make from selling drugs."
This is indeed a sad but true fact of cancer care. As patients, we need to feel that our physicians have our best interests at heart, and I genuinely believe that most physicians do. But the system itself does allow for the possibility that certain drugs may be prescribed because they are most profitable.
In the case of RIT, doctors must refer patients to radiation oncologists who then administer the drugs. This means that the referring doctor does not sell the drug, thus does not profit from it.
I have heard numerous stories from patients whose doctors do not discuss RIT with them, and yet evidence from clinical trials proves that it is beneficial. Last year, less than 5% of the lymphoma population who could have taken RIT got it. I cannot help but wonder if economics has played a role.
As has so often been stated, there are numerous philosophies on how best to treat NHL, and what one doctor suggests does not mean that another doctor whose opinion differs is wrong. What this does mean is that patients must do their own homework, sometimes seek different opinions, and make choices based on their own "creed," as Mort so nicely puts it.
As patients, I don't think many of us think of ourselves as "purchasing" medical services, but in effect, we are. It's a sad fact that when we are ill we have to consider that the world of business can potentially collide with our health, but it's another aspect we must all consider when making appropriate choices.
Betsy