SurvivorNet has received a wave of questions recently asking whether a doctor’s financial relationships, or the way they get paid, has any influence on the course of treatment recommended for cancer?
“As a physician, I got into the cancer field to help people. If money was the top priority I would have chosen a different specialty,” said one noted oncologist practicing in New York City. SurvivorNet spoke to numerous cancer doctors working at academic centers who said the same thing, but also said it’s perfectly fine for patients to ask questions.
Read MoreIf you’re curious about whether your doctor has any financial ties to drug companies, or any other sort of financial incentives or relationships – there’s no shame in asking. Financial ties in no way mean that a doctor’s decisions are compromised, and very little research turns into widely available treatments without the backing of the bio-pharmaceutical industry.
Dr. Flores says that patients have every right to ask about financial incentives linked to certain drugs, pharmaceutical companies, and surgery statistics.
This issue of financial incentives is complex and varies across medical specialties and hospital systems. The financial relationships which some cancer doctors have with the companies that sponsor cancer research has come to light in recent months, as several high-level medical researchers failed to disclose their ties to pharmaceutical and health care companies when publishing their research in medical journals. Reporting from The New York Times and a public interest journalism organization called ProPublica found that dozens of medical professionals in recent years have failed to mention these conflicts of interest.
One example highlighted by The New York Times is the president-elect of the American Society of Clinical Oncology, Dr. Howard Burris III, who apparently declared that he had no conflicts of interest in more than 50 journal articles published over the past few years. Dr. Burris, who works at the Sarah Cannon Cancer Center, failed to disclose that drug companies have paid his employer nearly $114,000 for consulting and speaking services, and almost $8 million for research Burris conducted during the period where disclosure was required. The most senior physician at The Memorial Sloan Kettering Cancer in New York was forced out of his job this year after similar questions about his failure to disclose financial ties to drug companies.
To be clear, there is no illegal activity alleged, the questions here involve standards, ethics, and transparency.
So what should you do to if you are concerned about what your doctor’s financial relationships could mean for your care?
Here are some things to consider, from some of the physicians SurvivorNet has interviewed over the past year.
- Make sure you have a good relationship with your doctor. That’s easy to say, but it matters deeply. You want to make sure you’re working with someone with whom you feel comfortable. “If you don’t feel comfortable calling your doctor, find another doctor – period,” says Dr. Scott Strome, an accomplished researcher who is now the Dean of the College of Medicine at The University of Tennessee.
- Ask about costs: If your doctor is recommending an expensive treatment, you can ask about the risk v. benefit, and you can inquire about conflicts of interest. “I would be a pretty bad doctor if I didn’t talk about the costs of drugs with my patients,” says Dr. Mikkael Sekeres, Director of the Leukemia Program at Cleveland Clinic Cancer Center. “If I just wrote a prescription willy-nilly, handed it to my patients and said good luck paying $120,000 a year for a drug.”
- Do some research: Even though a relationship with your doctor or surgeon is a huge part of every survivor’s cancer journey, being your own advocate is a big one too. Look into the drugs or treatments your doctor is recommending, and make sure you’re working with someone who will take your personal concerns into account. More expensive doesn’t always mean more effective.
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