Follow the mammogram money

MarieKelly

Madalyn,

I don't have an oncologist, but the one I consulted with immediately after my diagnosis didn't recommend any chemo. That was almost 6 years ago and he was following the older standard (before the days of oncotying) regarding automatic chemo for anything over 1 cm. Since mine was just under 1 cm, no chemo. He wouldn't have any significant financial incentive to suggest otherwise anyway, because he's partnered with the hospital and his office is within that facility.  So, it's the hospital who buys and bills for the drugs and his oncology practice just administers them . The hospital has a formulary list and whatever drugs the hospital carries on it's formulary are the drugs that are available to choose from. Since he's not buying and reselling, it should make no difference to him, in terms of potential financial profit, which are chosen to treat the patient.

But simply administering the chemo is not the concern raised here anyway. And decisions on whether or not to do chemo in the first place are not really the issue either - that's dictated by standards guidelines and more recently the additional information obtained from genetic tumor analysis.The issue is regarding those oncologist who DO buy and sell chemo drugs and the financial incentives made possible by this practice.

iodine

Very well said, Maddie, thanks for the calm words.  Wish I had them,too.

Yazmin

iodine, you wrote: ".............Until you have that kind of responsibility to keep you awake at night either reading up on your specialty, or being worried about a patient (and their family ) for whom YOU are responsible............"

Well, if indeed you have a list of oncologists who stay awake at night worrrying about their patients, you would do everybody a major service by posting it everywhere. Most doctors in this medical system are so busy making enough money, and fighting insurance companies for every little thing, that they obviously don't have time to stay awake at night worrying about patients.

Unfortunately, this entire system is plagued by all those conflicts of interest, and it is has turned into a giant money-making machine.

AnnNYC

Yazmin, doctors who are "fighting insurance companies for every little thing" are doing so on behalf of their patients.

Caring oncologists?

Ruth Oratz, MD - New York

Eric Winer, MD - Boston

Vicente Valero, MD - Houston

Edgardo Rivera, MD - Houston

I know there are thousands of names that belong on such a list, but these are the names that come to the top of my head.  Others' names I don't know, but I know they call my friends (from these Discussion Boards) on weekends, on vacation, whenever needed...

pip57

Geez, I am pretty sure my onc cares about me and her other patients.  She confers with her partners about each and every case.  She sees me at a moments notices.  She seems genuinely happy when things are going great and concerned if I have an issue.  She never rushes me.  She answers my and my dh's questions.   

If she really doesn't give a crap, she would probably be able to make more money in Hollywood as an actor. 

Rico

Add my onc to the list of those who care about their patients. I volunteer at the hospital on weekends and see him frequently. I also know that he provides palliative care for the local hospice. I can't imagine there's much money to be made there.

pip57

I should also add that I am in Canada.  She certainly isn't in it for the  money!

Ezscriiibe

Rico said: " I also know that he provides palliative care for the local hospice. I can't imagine there's much money to be made there."

And even if there were, I'm not seeing a down side. People who need it get the care they need, and someone who earns a living gets paid for earning a living.

I've never understood the disdain for people making money. 

I don't expect my doctor to work for free. He, like many other doctors, has investments in various aspects of the field they know most about, medicine, medical equipment, medical care centers.

When my insurance company knocked my primary care doctor out of their network, my doctor worked with me to keep my out-of-pocket costs down. He charged me only what my previous co-pay used to be, and when I needed lab tests, such as my quarterly hbA1c, he just wrote up the order so I could take it to one of my in-network labs instead of using the one that's in his own office. 

Are there doctors who behave unethically and engage in conflict-of-interest, sometimes to the detriment of their patients? I would say, yes, but I would also say that is the exception more than the rule.

Yazmin

Actually, I should add the Cancer Treatment Centers of America to the list of caring oncologists. I don't know every oncologist, of course, but Dr. Winer's willingness to tell the truth proves that he is most definitely one highly caring doctor.

No, what I meant to say is that doctors should be freer to treat patients without having to fight through a maze of administratrive issues AND financial worries that are caused by conflicts of interest. Also: they should be able to depend on innovative research that is not entirely dependant on humongous financial interests.*

I apologize for being unclear in my previous post: I have been posting out of airport terminals ): 

AnnNYC

"doctors should be freer to treat patients without having to fight through a maze of administratrive issues AND financial worries that are caused by conflicts of interest. Also: they should be able to depend on innovative research that is not entirely dependant on humongous financial interests."

Yazmin, I totally agree with that !!!!!!!!  Hope the airport terminals are minimally frustrating and the trip itself is a good one!

iodine

I'm one of those folks who has rec'd phone calls after (MY) bedtime from a doc to see how I am, and if such and such worked as expected or to explain, personally, why he was called away when I had an appt with him.

My onc., David Johnson, Vanderbilt Med. Ctr., Nashville, treated 2 of my VERY best friends and yes, I've spoken to his family and he's been up at night worried about a patient and/or reviewing research, etc.  I've listened as docs have called other docs at odd hours to discuss a patient, a new or OLD treatment, lots and lots of things.  As a nurse, I've seen them worn, hungry, without sleep, or days off, taking care of a patient or a lot of them.  I've seen them fall asleep at the foot of a patient's bed, (day and night time, LOL) waiting for fluids to finish or a med to take effect.

I have seen the absolute opposite as well, and all this comes from being in the profession since 1961, and working with medical professionals literally all over the world.   True, they were all US professionals, not had an opporturnity to work with others in their own country, just ours.

The thing is: we must not paint all of ANYTING/ANYBODY with the same brush. 

Yazmin

Dear AnnNYC: To answer your question, the airports are HUGELY frustrating. Yesterday, finally flying back from Paris Charles de Gaulle airport, it took us 4 (FOUR) hours to get checked in: we were searched from top to bottom before customs, and hand-checked, patted down, then searched all over again with that metal detecting hand device AT THE DOOR of the aircraft!

But who is complaining? ):