Conflicts of interest are ubiquitous in health care. In short, most doctors make more money by doing more. In cancer care, fee-for-service doctors who administer chemotherapy make more money. According to a story on Fox News, fee-for-service cancer doctors freely admit the more they do the more they get paid. If getting paid more to do more isn’t a conflict of interest, what is? Click here to read the full article.
In cancer care more and more chemotherapy is not necessarily the best treatment. In Econ 101 you learn about the Law of Diminishing Returns. Example: if you are growing a plant and you add a certain amount of fertilizer the plant will grow better. But if you keep adding more and more fertilizer you can kill the plant, hence The Law of Diminishing Returns. Overuse of chemotherapy can harm and even kill patients.
One softball recommendation in the article is,”…patients should feel free to ask doctors whether they’ll benefit financially from their treatments.”
Benefit managers, this is in your hands. Go to your PPO and tell them to start the process of culling cancer doctors who over-treat for profit, a practice that is not only costly but one that creates a huge amount of patient misery. You owe this to your plan members.
Tom Emerick is the President of Emerick Consulting, LLC, and Partner and Chief Strategy Officer with Laurus Strategies, a Chicago-based consulting firm. Prior to starting his consulting career, Tom was with Walmart Stores, where his last position was Vice President, Global Benefit Design, which involved designing and managing benefits for over 1.3 million employees in the U.S., and 300,000 plus in international. For about six years, Tom also headed up Walmart’s Six Sigma and process improvement initiatives. Prior to Walmart, Tom had positions with Burger King Corporation, British Petroleum, and American Fidelity Assurance Company. In 2009, Tom was named by Healthspottr as one of the top 100 innovators in healthcare the US for his work on medical ethics. In December 2012, Tom was listed in Forbes.com as one of 13 unsung heroes changing healthcare forever.