Ethics of Dr. Pay and Cancer Trials

Health Care

doctor'sbag185opt Washington I can’t seem to escape the conclusion that the pay of doctor’s is not only a real problem in the health care insurance debate right now, but also it seems doctors’ pay is a problem in doing what is necessary to create healthy patients.  A story by Gina Kolata in the Times about the lack of progress in the 40-year fight to cure cancer, noted deep in the article that if docs didn’t have their beak in the money trough, they were keeping their patients out of trials for new cures.  Disgusting!

“In any case, the great majority of oncologists just steer clear of studies.  They make little or nothing on trails, and, in fact, often lose money.  These doctors also may discourage patients from going elsewhere to enter a trail:  if a patient leaves, the doctor loses business.

“One issue is the money lost on chemotherapy, the source of 60 percent to 80 percent of the revenue at oncologists’ offices.  The doctors buy drugs and are reimbursed by insurance for slightly more than the drugs’ cost.  But if patients are in clinical trials, the drugs may be paid for the federal government or a drug company sponsoring the study – and the doctors get nothing.

“Then there is the poorly reimbursed hour or so it takes to explain a trail to prospective patients.  And, after all that, most patients either turn down the trials or, after further testing, turn out to be unqualified.

“That is just the start, cancer specialists say.  There is voluminous paperwork.  And the risk of legal liability for errors like neglecting to mention a financial interest in the drug being tested, in specimen handling or in billing.”

There are also a lot of reasons involving time, trouble, and money for the sick patient and their families, but having doctor’s economic self-interest potentially trump patient health is enough to make all of us sick.