No, happy patients do not make self-referral OK
The push-back by Chesapeake Urology and its patients against Tuesday's column on self-referral has already started. A former colleague and CU patient emailed me yesterday about what great treatment he received. Today there's a letter to the editor from the pastor of Zion Baptist Church.
Last year, I was diagnosed with prostate cancer. I was concerned, but knew exactly where to turn. Over the past two years, I had worked first-hand with Chesapeake Urology Associates, an organization that brought free prostate cancer screening to my congregation and to other Baltimore City communities.
This is completely beside the point. I'm sure there are thousands of satisfied Chesapeake Urology patients. Why not? They aren't paying the tens of thousands of dollars for the IMRT treatment (taxpayers and insurance companies are) and they're in no position to judge whether that was the right therapy.
The doctors there are no doubt very nice. I hear they have a buffet or something for patients waiting to get zapped. But happy customers do not refute arguments against the conflict of interest that self referral represents. If you want to present evidence showing that in general self-referring doctors do not overutilize the system, fine. (I don't know of any.) If you want to try to show that self-referral saves the system money on net by keeping treatment under one set of docs, great. (It doesn't.) If Chesapeake Urology wants to release patient treatment data to show that it doesn't conform to what the research shows generally about self-referral, great.
But saying "my treatment there was really successful and convenient, and what wonderful caring doctors!" does not end the discussion.
Comments
Funny that they would have a buffet for patients in the waiting room.
I wrote something before comparing "free" (government provided) healthcare comparing it to a Chinese buffet. I wonder if they were aware of the connection when they thought to install a buffet?
Posted by: John J. Walters | May 19, 2011 12:08 PM
I've seen no "push-back" from Chesapeake Urology. Did I miss something?
I received an email from one of their physicians yesterday criticizing the column on nonspecific grounds. I replied and offered to continue the discussion. JH
Posted by: Wendi | May 19, 2011 4:19 PM
Healthcare is a business, nothing more, nothing less. The goal is to make money.
Doctor’s are people, nothing more, and nothing less. There are good ones and bad ones, greedy ones and generous ones.
Self referral is a blatant conflict of interest. There are no valid arguments against reducing self referral by physicians that are not based upon greed.
Posted by: JJ | May 19, 2011 6:00 PM
The information that you really need to see is how the pattern of treatment for prostate cancer changed when this group got their IMRT machine. IMRT was certainly available prior to their purchase. How many patients received IMRT prior to Chesapeake Urology buying their machine? How many of the doctors at Chesapeake Urology changed their "preference" in treatment from seed implantation to IMRT? How many men in the over 75 age group have gotten IMRT for low risk prostate cancer that would not have affected survivability?
Thanks to Mr. Hancock for shedding the light of investigative reporting on what certainly appears to be a blatant conflict of interest. The real question remains: What will happen the the US Inspector General takes a look at the change in pattern of practice and issues with self referral.
Posted by: hmfic | May 20, 2011 3:14 PM
Chesapeake Urology Associates (CUA) is entertaining offers to buy their center. They claim the center generates $8 Million per year and they want 5 years of revenue for the center ... $40 Million Dollars!?!?!? The max value for the entire center with the linear accelerator is probably around $10 Million. Of course, that $8 Million per year estimate is from treating almost all of the prostate cancer patients from over 40 Urologists all over the Baltimore area. Do they expect those referrals to continue after the Urologists stop getting paid to send patients there? Maybe CUA is willing to continue that referral pattern if they can get one big pay day up front ... but of course that would be highly illegal too.
Posted by: NoMoreUroRads | May 25, 2011 4:14 PM
@nomoreurorads on May 20 you commented on the letter, "Patients have the Right to Choose Treatment Options.
. "If CUA truly feels that the care the patients receive at the Owings Mills Facility is superior then take away the financial incentive, sell the center to a 3rd party so there is no financial conflict of interest and keep sending patients there" Now you are complaining because they may be considering just that. It seems to me that you won't be happy no matter what CUA does. Could it be that you are a former CUA doc yourself and left with a bad taste in your mouth? I dare say if that is indeed the case, (I'm sure you wont admit it if it is) and you were still employed there your view would be much different. In addition you say that all CUA docs are in it for the money. Let me ask you- how many square feet is your home and what kind of car do you drive,Doctor?
Posted by: Wendi | May 26, 2011 1:11 PM