Conflicts Of Interst In Medical Care Abound
Profit and Questions as Doctors Offer Prostate Cancer Therapy
The big pharmaceutical companies have their hands in almost every doctor's office, clinic or medical center. These folks give away more trinkets and posters, especially pens, to staff and doctors everywhere they visit. But they jack up the prices of their drugs, manipulate the patent runouts on their most revenue generating drugs (i.e. Lipitor and Norvasc, which have now been combined to extend the patent protection of each), and ship off soon-to-be-expired drugs to third world markets... all the while making deals with governments not so set upon corporatism as is the US to have drugs delivered at a third of the cost.
The medical equipment folks are not much better. They continually market "new and improved" medical equipment so that the hospitals and medical centers can upgrade their resources, and charge more for the same service because they bought a new piece of gear. While it is certainly important to have new technologies added to the repertoire of medical services, it is not always necessary to have the newest and most improved technollogy on hand in every hospital. But hospitals, especially those having not-for-profit status, receive their funding based upon an outdated, out-moded and convoluted funding process that does not support those that provide good quality care, but those that are always buying more equipment and doing more with technology.
There are tons of folks in the business of screwing Medicare, but that is so easy because Medicare (as well as Medicaid) are so screwed up to begin with.
Then there are doctors, coerced by unfair hospital policies and practices, that do unnecessary procedures because it generates revenues, prestige and reputation for the doctors and the medical centers. Most notorious are unnecessary hysterectomies. But that is now being superceded by the number of unnecessary cosmetic procedures... and most of the hospitals are excluded from tapping these revenues because most "plastic surgeons" now run their own surgery centers.
Then there are the managed care organizations that are so motivated by profits that the original model of preventive medicine is no longer valid... and what we are left with is an inadequate medical care system and a ripoff approach that favors insurance companies over patients, death over healing, disability over prevention, and profit over valuing life, health and people.
But this NYT article points to the motive of greed in forcing diagnoses to include a profit-making treatment rather than less costly, equally effective methods... Methinks medicine is reaching new lows.
The big pharmaceutical companies have their hands in almost every doctor's office, clinic or medical center. These folks give away more trinkets and posters, especially pens, to staff and doctors everywhere they visit. But they jack up the prices of their drugs, manipulate the patent runouts on their most revenue generating drugs (i.e. Lipitor and Norvasc, which have now been combined to extend the patent protection of each), and ship off soon-to-be-expired drugs to third world markets... all the while making deals with governments not so set upon corporatism as is the US to have drugs delivered at a third of the cost.
The medical equipment folks are not much better. They continually market "new and improved" medical equipment so that the hospitals and medical centers can upgrade their resources, and charge more for the same service because they bought a new piece of gear. While it is certainly important to have new technologies added to the repertoire of medical services, it is not always necessary to have the newest and most improved technollogy on hand in every hospital. But hospitals, especially those having not-for-profit status, receive their funding based upon an outdated, out-moded and convoluted funding process that does not support those that provide good quality care, but those that are always buying more equipment and doing more with technology.
There are tons of folks in the business of screwing Medicare, but that is so easy because Medicare (as well as Medicaid) are so screwed up to begin with.
Then there are doctors, coerced by unfair hospital policies and practices, that do unnecessary procedures because it generates revenues, prestige and reputation for the doctors and the medical centers. Most notorious are unnecessary hysterectomies. But that is now being superceded by the number of unnecessary cosmetic procedures... and most of the hospitals are excluded from tapping these revenues because most "plastic surgeons" now run their own surgery centers.
Then there are the managed care organizations that are so motivated by profits that the original model of preventive medicine is no longer valid... and what we are left with is an inadequate medical care system and a ripoff approach that favors insurance companies over patients, death over healing, disability over prevention, and profit over valuing life, health and people.
But this NYT article points to the motive of greed in forcing diagnoses to include a profit-making treatment rather than less costly, equally effective methods... Methinks medicine is reaching new lows.
The nearly 240,000 men in the United States who will learn they have prostate cancer this year have one more thing to worry about: Are their doctors making treatment decisions on the basis of money as much as medicine?
Among several widely used treatments for prostate cancer, one stands out for its profit potential. The approach, a radiation therapy known as I.M.R.T., can mean reimbursement of $47,000 or more a patient.
That is many times the fees that urologists make on other accepted treatments for the disease, which include surgery and radioactive seed implants. And it may help explain why urologists have started buying multimillion-dollar I.M.R.T. equipment and software, and why many more are investigating it as a way to increase their incomes.
Already, dozens of the nation's 10,000 urologists have purchased the technology for intensity modulated radiation therapy, which is what I.M.R.T. stands for, and some of them are recommending its use for growing numbers of their patients.
Critics see a potential conflict of interest on the part of urologists, the specialists who typically help prostate patients choose a course of treatment. The critics say that urologists who can profit from the new form of therapy may be less likely to recommend other proven approaches, which for some older men can involve forgoing treatment altogether.
If the patient has insurance, the added expense may not be a concern for him. And like the other treatments, the new therapy can be highly effective. But doctors say that prostate cancer treatments should be tailored to the individual.
Compared with seed implants, for example, I.M.R.T. involves a large time commitment, requiring patients to visit a radiation center 45 times over the course of nine weeks.
More worrisome for some experts is a concern that the multiple-beam radiation of I.M.R.T. may raise the risk of secondary cancers, although no medical studies have proved such a link.
Helping drive the trend is a Texas company, Urorad Healthcare, which sells complete packages of I.M.R.T. technology and services, and hopes to persuade even more urologists to buy them.
''Join the Urorad team and let us show your group how Urorad clients double their practice's revenue,'' the company says in a marketing pitch to doctors on its Web site.
Urologists who have purchased the new multiple beam systems say they are embracing a superior way to treat prostate cancer. But because there is little research directly comparing I.M.R.T. with the other treatments, there is little consensus among urologists about which approach is best.
That is why some doctors worry that I.M.R.T. may be emerging as yet another example of the way financial incentives can influence medical decisions in this nation's for-profit health care economy.
posted by Jim Downey at 8:47 PM
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