Patient care should always come before a doctor’s wallet. However,
studies continue to find that financial conflicts of interest can compromise
medical treatment. In the latest study, researchers found that older patients
diagnosed with prostate cancer are more likely to be treated with radiation
when their doctors own the radiation equipment.
Reuters reports, the study analyzed patient data for over 31,000 men aged 65 and older
who had been newly diagnosed with prostate cancer. The goal was to determine
how often patients received radiation, paying particular attention to
those who had little risk of dying from tumors over the next 10 years,
and to those with high odds of dying from another cause.
For patients with a 75% chance of dying from something other than cancer
within 10 years, physicians who owned radiation equipment treated 53%
of these men. Meanwhile, doctors without the financial incentive of owning
the equipment treated 44% of these cases.
When the researchers focused on intensity-modulated radiation therapy (IMRT),
the treatment disparity was even more significant. When doctors owned
IMRT machines, 42% of men with a high chance of dying from something other
than cancer received the treatment. By comparison, just 26% of men were
prescribed IMRT when physicians didn’t own the equipment.
The study findings are particularly concerning because radiation was recommended
even when the patients would not receive any benefits from the treatment
or when the patient would likely die from other causes before any cancer
symptoms became noticeable. In addition, many of the patients could have
avoided the side effects of treatment, which often include impotence and
“Patients should be aware that financial incentives of their provider
can influence how they are treated for their prostate cancer,” said
lead study author Dr. Brent Hollenbeck of the University of Michigan in
Ann Arbor. He added: “Urologists in some single-specialty groups
with an ownership interest in IMRT were more likely to treat, and even
overtreat, patients with IMRT than urologists affiliated with a multispecialty
practice or a group without an ownership stake.”
Self-Referrals Create Conflicts of Interest
Physician self-referral occurs when a physician orders a service for a
patient that is performed either by that individual physician or by a
facility from which they derive a financial benefit for the referral.
While federal regulations prohibit certain transactions, doctors can often
skirt restrictions on self-referral by joining with other doctors to open
free-standing radiation or other types of facilities, such as a group
of urologists opening a radiation treatment center.
While these facilities may be legal, they do raise conflict-of-interest
concerns regarding whether referral decisions are motivated by profits
rather than what is best for the patient. In some cases, the patient may
not be given fair and accurate information about the choice of treatment
If you or someone you love has suffered serious harm due to overtreatment
or another serious medical error, the Law Offices of Robert Vaage is here to help. Contact a San Diego medical malpractice lawyer at our office for a free consultation.