Prostate Cancer Caveat Part II

A few days ago, I wrote about Jane and Max, and Max’s diagnosis of prostate cancer.  Max was told he needed a prostatectomy and was trying to decide between laparoscopic and robotic surgery. 

A comment from “hERB” reminded us that Max might have other options, too — radiation, cryosurgery, hormone depletion and others.  The point being — perhaps Max should be looking at options beyond surgery.

And hERB (is that really how you spell your name?!?) is absolutely right — and it’s worth writing about because smart patients realize there are often options beyond what their doctors tell them.

As I’ve reminded patients before — that sometimes, part of our decision-making requires us to follow the money.  Whether we want to believe it or not, doctors will way-too-often make recommendations for us that line their pockets, too.  A surgeon is trained to perform, and GETS PAID FOR, doing surgery.  That’s true whether we are talking about prostate surgery or brain surgery.

About a year ago, I heard from another gentleman, Bob, who has a brain tumor and was told he needs surgery.  His neurosurgeon wouldn’t discuss any other options with him but surgery.  Bob asked me how he could get the neurosurgeon to discuss other alternatives with him — including nutrition and natural remedies.  You already know what I told him!  A surgeon, who only GETS PAID FOR surgery, isn’t going to discuss any other options with Bob.  I suggested Bob find himself another doctor to discuss those options with.  (And — I just heard from Bob again yesterday — he did find another doctor, and he continues to pursue natural remedies, a pursuit which empowers him in many ways.)

And it’s not just surgeons.  Earlier this week, I also wrote about oncologists MAKING MONEY FROM the chemo they recommend for the “infusion centers” they own.  Many other doctors are now setting up their own testing centers, or purchasing the testing machines for their own practices.  They are consistently on the lookout for alternatives ways TO GET PAID.

Here’s the thing — in many cases, and because I was a business person long before I was an advocate — I understand exactly why doctors set themselves up to profit in all these other ways.  It’s really just good business to create profit centers.  Doctors spend a lot of time in school, they have education loans to pay off, they set up state-of-the-art practices which are very expensive to run, they hire educated staff who deserve decent pay checks.  Most doctors deserve high incomes and as insurance companies continue to squeeze them, they seek alternative sources of income. 

And we patients can certainly benefit from all this technology and profit-basing…. BUT…. we have to be smart about it.  Once it’s in place, doctors will want to, and deserve to, profit by it.  So — as sharp patients, we simply need to make sure we take all aspects of our treatment into account — making sure it’s the right treatment for US, and not simply extra profit for the doctor. 

Getting the best treatment, and profit making, are not necessarily mutually exclusive.  But they do necessarily require review and examination, and consideration about whether they pave the right road to the patient’s best outcome.

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