Dr. Len's Cancer Blog

There is an article on the front page of this morning’s Wall Street Journal describing the experiences of a Texas woman diagnosed with acute leukemia who had to come up with hundreds of thousands of dollars before she could be treated for her life-threatening disease.

The basic premise of the article is that hospitals are no longer going to treat first and bill later.  The rising number of uninsured patients and those who do not pay their bills is reportedly creating an increasingly severe burden on non-profit hospitals, which in the past would have absorbed the costs.

I can’t say that I am surprised that this is going on.  I am surprised that it has taken so long for the issue to get attention.

There is a quiet, early revolution going on in medicine.  We are beginning to redefine how we provide primary care, moving from a traditional “one on one” patient/doctor relationship to a new model which emphasizes a medical team providing patient focused care.

The name of this new model of care is usually referred to as a “patient centered medical home,” or some variation of those words.  The impact of this change—which will take years to better define much less accomplish—has the potential to be enormous and transformational.

If done right, this effort has the potential to vastly improve the care we provide our patients, emphasizing prevention as well as more effective, evidence-based primary care medicine when someone develops an illness or a chronic medical condition such as diabetes or heart disease.

If you want to understand why some of us are concerned about conflicts of interest, you need go no further than an article that appeared in last Friday’s edition of the Cancer Letter.

The Cancer Letter article, written by Paul Goldberg, goes into great detail to explain why a scientific review on vitamin D, sun exposure and tanning booths which appeared in the New England Journal of Medicine last July may have been influenced by tanning industry funding.

The fallout from this conflict, in my opinion, may have substantial negative impact on how we are able to regulate tanning bed use, especially among young women who are putting their health at risk from the adverse effects of articial tanning.

The headline on the CBSNews.com website is loud and clear: “The Kanzius Machine: A Cancer Cure?”

The story goes on to promote an interview which is being broadcast this Sunday night on 60 Minutes.  The interviewer is Lesley Stahl, and the interviewee is John Kanzius.

Mr. Kanzius’ story is an interesting one.  According to various news stories, Mr. Kanzius has terminal leukemia, which has been under treatment for six years.  His experience with his disease and his treatments has focused him on developing a treatment for cancer that will be more effective and less toxic.

Unfortunately, in my opinion, the headline is terribly misleading for patients whose lives may be hanging in the balance.

As I write this, I am returning from a trip to Boston where I had the opportunity yesterday to participate in a hearing hosted by the Social Security Administration. 

The topic was “Compassionate Allowance Outreach,” and the issue was how to hasten Social Security disability benefits to patients diagnosed with cancer.

Disability is something that many of us don’t like to think about.  In particular, Social Security disability usually means that you are completely disabled and that the disability is long term, as noted in a Social Security booklet entitled “Disability Benefits.”

The problem for certain cancer patients is that the benefits they have earned and deserve may not show up until it is too late to be of help.

It has been a pretty hectic and busy couple of weeks, with travel, meetings, work, and a short vacation.

While I have been otherwise occupied, a lot has been happening.  Unfortunately, much of it hasn’t had to do with advancing the treatment and science of cancer.    Instead, we have learned more than we should need to know about the inner workings of our profession and how research and practice are being supported in the new millenium.