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Cancer Treatments and Care

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Jul 5, 2007

Doctors and Money: The Rising Cost of Cancer Care
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It is no surprise that doctors earn a living caring for patients, and that cancer specialists are paid to care for cancer patients. But many may not be familiar with how doctors in the US are paid, nor how closely linked are specific treatment recommendations and doctor's earnings. In the next several blogs, I wanted to touch on aspects of doctors and money.

The issue of oncologist earnings has been put forward recently as part of a larger emerging dialogue that centers on the growing cost of cancer care. Because of progress in helping treat cancer and alleviate symptoms in cancer patients, the cost of cancer care is continuing to rise steadily. Much of this may represent genuine progress - the availability of new, effective anti-cancer drugs, and the utilization of better supportive care have been dreams for patients and doctors for decades. But such progress comes at a cost. An aging population, longer survival with cancer, higher prices for new drugs, and rising expectations for fewer side effects all have contributed to increasingly expensive oncology practices.

In medical oncology, physicians (or their group practices, hospitals, or affiliated cancer centers) are paid both for consulting services - that is rendering opinions and guidance - and for delivering care with chemotherapy or other interventions. This creates the potential that treatment choices are driven by consideration of financial remuneration. This is not fundamentally different from other medical specialties (for instance, surgeons get paid to operate), or for other professions (lawyers are paid for services they render). But the implications in oncology, where there are more and more treatment choices emerging, are only beginning to be studies.

A recent article in the New York Times highlights some of the areas of controversy for doctors and patients, and money.

I would be interested in your experiences. Do you think that your treatment, or aspects of it such as drug choices or schedules, have been influenced by the kind of reimbursement the medical team got? If so, add your voice to the discussion.

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Posted by: Harold Burstein, MD, PhD at 4:40 PM

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