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In Rush to Promote High-Tech Treatments, What About Patients?

Marianne Aiello, for HealthLeaders Media, May 1, 2013

Here's the thing—both organizations acknowledge that research has yet to demonstrate that the treatment is better than conventional therapy for other cancers, such as prostate, even though many hospitals want to use proton therapy to treat that disease. And they aren't the only ones moving ahead with the costly therapy before the verdict is in.

Even the venerable Mayo Clinic is building two proton beam facilities. Why? "Because it's competing against Massachusetts General Hospital, M.D. Anderson in Texas, the University of Pennsylvania, [and] Loma Linda in California —all of which have one," Ezekiel J. Emanuel, an oncologist and vice provost at the University of Pennsylvania, wrote in the New York Times last year.

And Scripps Health in San Diego will have one this fall. Until recently, Scripps and UC San Diego Medical Center were poised to move forward with competing proton beam centers within 5 miles of each other. UCSD, citing "a lot of simpler solutions" coming down the road, has since opted to pursue a smaller project involving a different technology.

Why aren't more hospitals being this cautious? You guessed it—money.

Hospitals using proton technology receive higher Medicare reimbursements than those using conventional radiation; for example, $32,000 per patient compared with less than $19,000 for prostate cancer treatment, according to a recent study in the Journal of the National Cancer Institute.

Questionable Robotic Surgery in MA
A similar technological arms race has been unfolding in Massachusetts, where the state has recently cautioned hospitals about robot-assisted surgeries. State health officials sent hospitals an advisory letter in March alerting them to safety concerns based on a rise of reports of complications from robot-assisted surgery.

"In some cases, it appears that doctors have used the aggressively marketed robots to perform hysterectomies and colorectal operations that were too complex for the technology, or for the surgeons' skill level in directing the robots' actions," The Boston Globe reports.

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1 comments on "In Rush to Promote High-Tech Treatments, What About Patients?"


M. Bennet Broner, PhD (5/3/2013 at 2:32 PM)
I am surprised that health insurers do not take a more rigorous stance on paying for unvetted technologies as it would not only protect their subscribers, but their bottom line as well. That said, I would prefer a federal agency do this as is done in other countries. At the least, federal control would reduce the vagaries that would occur among private insurers.