Tuesday, February 12, 2019

Bills can be as bad for patients as side effects

Lack of money may adversely impact health of cancer patients, says AARP article

Surviving cancer may depend on what's in your savings account.

At least that's the conclusion of an article by Peter Moore in an edition of "AARP: The Magazine" a while back.

The piece suggests that average costs for the disease "run in the $150,000 range."

Why so much?

Moore postulates that "containing the cancer and killing [the] abnormal cells without damaging nearby healthy cells often requires a range of treatments, over an extended period of time — lengthy radiation, complicated surgeries, costly chemotherapy, plus other strong medications to supercharge your immunity."

Although new treatments emerge with regularity, he writes, "with new hope comes even more cost: 11 or the 12 cancer drugs that the Food and Drug Administration approved in [a recent year] were priced at more than $100,000 [annually.]"

Even with a good insurance policy, "a patient is probably looking at a bill of more than $4,000 in deductibles and co-pays."

Patients, of course, must often cope as well with "loss of income during months of treatment and recovery," not to mention travel and lodging expenses "at a cancer-centric health facility."

Plus the costs of myriad follow-up tests.

Moore notes that "not only are cancer patients two and a half times as likely to declare bankruptcy as healthy people, but those patients who go bankrupt are 80 percent more likely to die from the disease than other cancer patients, according to studies from the Fred Hutchinson Cancer Research Center in Seattle."

Dr. Gary Lyman
The AARP story also quotes Dr. Gary Lyman of that center: "For many patients, when they get the bills, it can be as bad as some of the side effects of the disease or the treatment."

Moore entertains the idea that many patients don't discuss their financial fears with their doctors, fearing such action could "compromise their treatment."

The result of that silence and fears, or from a patient lying because he or she couldn't afford to follow a prescribed regimen?

"Doctors [don't] know that their patients might take their pills less often than prescribed [and/or] avoid follow-up therapies or tests."

More details about what else impacts cancer patients psychologically can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at male caregivers.

Tuesday, February 5, 2019

600 old medical tests, treatments still used

Physicians have big trouble unlearning outmoded practices, New York Times writer claims

The public is paying more because it's hard for physicians to unlearn what they were taught long ago.

That — along with the notion that "procedures live on even after they've been proved ineffective," which "can lead to harms and wasted resources" — is the contention of a recent story in The New York Times by Dr. Aaron E. Carroll, a pediatrician.

The article leans on a review in JAMA Pediatrics magazine of "medical literature related to overuse in pediatric care" — finding "that we still recommend that children consume commercial rehydration drinks [that] cost more, when their drink of choice would do," that we "give antidepressants to children too often," that "we induce deliveries too early, instead of waiting for labor to kick in naturally," and that "we get X-rays of ankles looking for injuries we almost never find."

Overuse, the article maintains succinctly, "is rampant. And it can harm patients."

The Times specifically cites an initiative of the American Board of Internal Medicine Foundation, "Choosing Wisely," which it says is "entirely focused on the identification of care that physicians routinely recommend but shouldn't."

Almost 600 tests, procedures or treatments collected over six years, it claims, "are currently listed on their website. Almost all the recommendations basically say 'don't do' them."

But the public "shares some culpability," Carroll's story says: "Americans often seem to prefer more care than less."

Professional organizations are also to blame, the piece contends, because they "seem better at telling physicians about new practices than about abandoning old ones."
David Niven
Carroll asks David Niven, lead author of an earlier study, why it's so tough for docs to "discontinue certain practices. The researcher says "physicians have a hard time unlearning what they have learned, even when there's newer and better science available [in part] because they work within a system that doesn't adapt well to changing evidence."

More details on medical community attitudes toward treatments and tests can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.