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View Diary: Will you have access to Integrated Cancer Care under the PPACA? (37 comments)

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  •  There is much less here than meets the eye. (13+ / 0-)

    There are a bunch of big-name, high-cost marquee cancer care centers scattered around the country. Names like Dana-Farber, M.D. Anderson and so on come to mind.

    But the thing is, cancer care today is far more standardized and routine than the diarist suggests. Every oncologist in America has access to the same database of studies and 'best practices' protocols. For the overwhelming majority of cancers, particularly common varieties like breast cancer or colon cancer, outcomes are quite similar across various institutions, for the simple reason that most every oncologist is working from the same playbook.

    Yes, if you have a very rare kind of cancer you may benefit from access to one of the 'Meccas'. Or you may be invited to join a risky clinical trial exposing you to an experimental treatment that may well be less effective and/or more toxic than standard care.

    The business model of prominent  big-name cancer care centers is predicated upon getting desperate patients (or preferably their insurers) to pay more than the going rate for the perception of superior care. This expectation is not necessarily correct.

    •  And who do you think writes all those "best (5+ / 0-)

      practice" protocols.  The oncologists out in the community hospitals?  No, it is the physicians and researchers who are affiliated with the Comprehensive Cancer Centers.  And they get all the cancer "train wrecks" that a botched out in the community hospitals.  

      Every oncologist may have access to the protocols, but there is a big difference nationwide on outcomes over where you are treated.  And don't confuse every TV ad that screams Cancer Center or Cancer Treatment Center because they are not all alike.  

      And by the way, many of treatments that were once clinical trials are now the standard of care.  

      If I ever am unfortunate enough to have cancer, I am going straight to an accredited Comprehensive Cancer Center because they see cancer every day, and it does make a difference.

      And it feels like I'm livin'in the wasteland of the free ~ Iris DeMent, 1996

      by MrJersey on Fri Mar 21, 2014 at 09:21:30 PM PDT

      [ Parent ]

      •  Good quality research is done everywhere, (1+ / 0-)
        Recommended by:

        from university hospitals to 'comprehensive cancer centers' to community hospitals. The venue matters a lot less than the design of the study.

        For every 'cancer train wreck...botched out in the community hospital' I can point you to a desperate patient railroaded into a poisonous clinical trial or given inept, unfeeling cookbook care by under-supervised fellows & residents at a "comprehensive cancer center".

        Again, the entire business model of such centers is predicated on creating a perception of 'added value' for desperate cancer patients, frightening them into paying far more for care than at a community hospital, and getting enough insurers to go along to make a bundle, since you can only squeeze so much out of individuals.

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