A government investigation reveals that doctors who have a financial interest in a radiation center are more likely to prescribe such treatment for older men with prostate cancer, possibly leading to unneeded procedures, negative side effects and a bloated medical bill.
The New York Times reports that investigators from the Government Accountability Office (GAO) said Medicare beneficiaries were often unaware that their doctor stood to profit from prescribing radiation therapy. Alternative treatments might be equally effective, especially for older men, and less expensive for Medicare patients.
The GAO probe was launched two years ago and also covered doctor referrals for MRI and CT scans, a 2011 Washington Post story explained.
At that time, the executive director of one cancer center called the practice “a scandal” and told the Post, “Do you want your dad going to somebody who has a very highly incentivized reason to give him one particular treatment that is not necessarily in his best interest?”
External beam radiation therapy for prostate cancer involves using high-energy rays to precisely target cancerous tumors, according to the Mayo Clinic. The therapy can be effective, but in older men with slow-growing tumors, it may not be necessary. And there are risks of side effects, including impotence and incontinence.
The GAO report said doctors who recommend the treatment often have financial relationships with those who provide it, the Times notes. The government investigators pointed out that Medicare has no easy way to determine whether doctors had a financial stake in the radiation equipment or center to which they had referred patients.
Urologists “referred a substantially higher percentage of their prostate cancer patients” to radiation therapy when the doctors owned the equipment or had financial ties to those who provided the treatment, the report said.
“When you look at the numbers in this report, you start to wonder where health care stops and profiteering begins,” Sen. Max Baucus, a Montana Democrat who is the chairman of the Senate Finance Committee, told the Times.
Some urologists criticized the report, saying it overstated doctors’ financial motives and ignored the trend toward treating patients in doctors’ offices, which costs Medicare and patients less than treating them in a hospital.
Nonetheless, Michael L. Steinberg, M.D., chairman of the American Society for Radiation Oncology, which represents more than 5,000 doctors, told the Times that the report raises troubling questions about whether older men are receiving possibly unnecessary treatment. “Some physician groups are steering patients to the most lucrative treatment they offer, depriving patients of the full range of treatment choices, including potentially no treatment at all,” he said.
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