An Oncologist Speaks Out: Chemo Makes Us Money, But It Doesn’t Work

AntiCancerMom — Mon, 18 Jan 2016 05:01:54 +0000

Can you believe this picture?! My sister snapped it while waiting at a traffic light in Atlanta back in 2011. I couldn’t believe it when I saw it! I had just started my blog and had endured some brutal verbal attacks (about my holistic cancer healing story) on a popular cancer support forum, so I just wasn’t quite ready to talk so honestly about something like this.

I must confess that I’ve pondered some “let’s not assume…” kind of thoughts. Like “well, maybe it’s not an oncologist and it’s a foreign name, like “Kem Odoc”, or “Kemo D.” from the “OC” or something like that?

But after 5 years of hesitancy on publishing this picture, I think it’s pretty clear.

This person is a proud KEMODOC.

A Reasonable Look at Oncology:

Notice this doctor’s license plate does not say “HEALNGDOC,” “ONCODOC,” or “KANSRDOC.”

This picture provides much insight into the belief system of this doctor and the conventional medical model. Oncologists have been taught in their pharmaceutical-sponsored medical schools that the only thing that will cure cancer are drugs and other complicated, invasive medical treatments. In fact, if they believed and did otherwise, they would lose their medical license! It’s that serious.

The annual cost of cancer care in the United States projected to be $173 billion by 2020. The majority of cancer patients already well exceed $100,000 for the cost of their cancer treatment. Pharmaceutical cancer treatment makes oncologists A LOT of money.

Would you be surprised if I told you that in many cases 60-70% (or more) of an oncologist’s practice is coming from the sale of chemotherapy and other cancer drugs? This was really eye opening for me. In a way, oncologists are placed in a situation where the sale of chemotherapy and other cancer drugs is their livelihood. Most of the skillset they worked to achieve in their career would be rendered useless if they didn’t have chemotherapy to sell as treatment to their patients.

So could it be they are just part of a medical and financial model they find themselves stuck in?

The Current Model of Cancer Care Relies on the Subjective Morality of Your Oncologist:

Check out this letter from oncologist, Dr. Peter Eisenberg. It was written in 2009 as commentary around how the current healthcare model forces oncologists to rely on money they make from the sale of chemotherapy and other cancer drugs. It was originally published on Health Beat, a popular Healthcare reform and policy blog written by Maggie Mahar. Note that it is not a piece written to support holistic or alternative cancer treatment or put down chemotherapy. It is dealing with the doctor’s overall frustration of the Buy and Bill model of chemotherapy sales.

In it, Dr. Eisenberg, Medical Director at California Cancer Care, (now Marin Cancer Care) says:

“The reason oncologists have been able to grow a practice as large as ours and provide the level of service we do is because of the revenue we obtain from selling chemotherapy drugs and services….

“We are paid more for administering the drugs than we were in the past, so it makes economic sense to administer them more often. Not every doctor is willing to do that. The practices that shows some restraint and don’t treat everyone who walks through the door with chemo are the ones that are suffering….

“When doctors are paid to “do more” there is always the potential for conflict of interest. Keep in mind that physicians are human beings with the same kinds of responses to financial incentives as everyone else. Despite our training and promise to put our patient’s interest first, we succumb to incentives that often come in the form of more revenue.”

“It has taken me a while to sort out how I feel about the drugs we use. I began practicing in the late 1970s, and I remember the increasing role and influence of chemotherapy. As more drugs became available, with more evidence that they were effective, our optimism increased –and use increased as well.

It became clear to many physicians—consciously or not–that selling chemotherapy was really the business they ought to be in as we were compensated so very well for it. The time one spent with patients was not compensated nearly as well…

When doctors are paid to “do more” there is always the potential for conflict of interest. Keep in mind that physicians are human beings with the same kinds of responses to financial incentives as everyone else. Despite our training and promise to put our patient’s interest first, we succumb to incentives that often come in the form of more revenue.

As time went on and science grew, we became increasingly more successful in providing chemotherapy that actually worked, and it was a lot easier for doctors to sell chemotherapy than it was for them to spend the kind of time necessary to give patients choices.

Keep in mind that in the late ‘70s and ‘80s there was not much discussion about “shared decision-making.” If a patient had cancer, and we knew that tumors responded to a certain chemotherapy regimen by shrinking, physicians assumed that patients would choose to take it, if it was offered to them. “You have cancer, you need chemo,” seemed to be the mantra.

It was not until much more recently that the notion of quality of life, and the fact that just because we shrunk a tumor doesn’t mean that people will actually live longer, was clear to us.”

No Effective Chemotherapy For Most Cancers:

Then Dr. Eisenberg discusses the effectiveness of chemotherapy. I almost sense frustration in his writing about how truly ineffective the only tool he has in his toolbox is:

(Referring to a discussion with a patient with Stage 4 small-cell lung cancer…)

“So rather than making it clear that the average patient lives only a couple of month longer—and that the chances of surviving for a year are less than 50/50, it is much easier to say, “Yes, you do have a tough disease, but I think we can help you, so let’s start treatment tomorrow!

Of course, treating Hodgkin’s or another curable disease is something else, but most of the cancers we treat with chemo are not curable. Doctors need to be paid for the time it takes to explain the potential benefits as well as the downside of chemo—so that the patient can make a decision about how he wants to spend the time he has left…”

“The truth is that there is no clearly effective chemotherapy for a distressing number of malignancies. In those cases, if I find that first line therapy isn’t working, I won’t automatically offer a second type of chemo. Instead, assuming the patient wants a frank appraisal of her condition, I’ll explain the realistic goals and options available. In my experience, and in the community in which I live, patients seem to want to know as much as they can about their illness, even if the news is bad. Delivering terrible news is difficult, time-consuming and extraordinarily painful for all involved. But good decisions depend upon an honest and forthright discussion and providing the patient with the information and tools to make decisions.

…I have told patients, “I know that I can make you sick, but I am not certain that I can make you better! … In the foreshortened time that you have left, you need to think about what you want to do. Do you want to spend that time in this office, with me and my staff, or is there someplace else you would like to be, something else that you would like to do?”

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Chemotherapy may work in the short run in killing cancer cells and shrinking tumors, but I think what most people with cancer and their families are interested in is LONG TERM wellness, not short term tumor shrinkage and drug and doctor dependency.

I HIGHLY recommend reading the entire letter. Dr. Eisenberg seems like a reasonable guy. His honesty is refreshing and it provides some much-needed perspective to those in the natural health world that the conflict between conventional and natural medicine isn’t so black-and-white/ good-guys vs. bad-guys. In the end, greed can get the best of anybody.

I’d love to hear your thoughts! Feel free to comment below or on the my Facebook page.

Sources and Additional Reading:

A Very Open Letter From an Oncologist with Dr. Peter Eisenberg

Private Oncologists Being Forced Out, Leaving Patients With Higher Bills (with Dr. Eisenberg)

The High Cost of Cancer Care and What We Can Do about It (Mayo Clinic)

Study in Journal of Clinical Oncology: Are Oncologists’ Financial Incentives Aligned With Quality Care?

A List of 20 Questions For Your Oncologist Before Choosing Treatment

Study in Journal of Clinical Oncology: Medical Oncologists’ Perceptions of Financial Incentives in Cancer Care

The Reimbursement Process for Buy and Bill

And for a full archive at AntiCancerMom.com, check out: