Hello bOObs Bloggettes:

So today we’re diving into a deep dark secret of Medicine: Doctors get monetary kickbacks for prescribing things such as mammograms. How do I know this? If you’ve seen my film, you’ll see the paper trail right there on the screen. I was a little shocked when I discovered this. But it wasn’t the first time I’d heard of this scheme, so perhaps I shouldn’t have been. Let’s look into the abyss…

The kickback for mammograms came to my attention when an astute follower (keep those emails coming, folks! It really helps the cause) sent me something they’d come across: a Blue Cross “incentive” payment schedule for doctors in Michigan. It included all sorts of things, such as successfully keeping diabetics on their medication; $400 per child fully vaccinated with the CDC vaccine schedule; and paying docs $100 per patient who fulfill their mammogram screening.

I get it, they’re trying to “prevent” disease in patients by incentivizing docs with money. But first of all, is this really necessary? Shouldn’t docs be doing this anyway? Don’t they care about us patients without the additional monetary incentive? Isn’t that their job? And how is this even legal?

I’ve noticed how pushy doctors are when it comes to writing the mammogram prescriptions every year and insisting I “get a screening soon”, so now I’ve grown suspicious: Is it me they care about or the kickback in the form of an “incentive”?

And where do these incentives stop? Are they doing the same thing for CT scans and other high-dose radiation diagnostic tests that the patient in the end may not have needed and may also induce cancer? As a consumer, I’d like to know what else is incentivized in medicine? How deep does this go?

Well, one place it goes is chemotherapy.

I wanted to warn my followers about this in case any of you or a loved one, God forbid, ever needs chemo: The New York Times reported on this in 2007 that oncologists had been acting as a type of Middle Man between chemo pharmaceutical companies and the patients, the docs thereby earning an impressive pot of money by the end of the year (see attached NYT article on how this was carried out).

When I told my husband this little factoid as we were driving to his first oncology appointment after being diagnosed with Stage 4 BAC lung cancer, he didn’t believe me. And as I had only heard about the article second hand I couldn’t refute much. But when someone at our appointment that day decided to challenge the doctor with this info, he indeed confirmed that he would go out of business if he didn’t tweak the chemo schedule somehow. So what does that mean?

In this importantly telling NYT article, one doctor indeed discusses Medicare changing the payment schedule for chemos: Today, the majority of oncologists break even, and some lose money on drugs.”  

Here’s the article:

https://www.nytimes.com/2007/06/12/business/12cancerpay.html?ei=5070&en=1b49d9a0efe3c01&fbclid=IwAR15EELt0PQ7kIcM-kXpczhe-cB4Y9EMxEGHWdGe4qMvK-Oi4zKfKQDxjTw

The Times goes on to say this: “Some physicians say that cancer doctors responded to Medicare’s change by performing additional treatments that got them the best reimbursements, whether or not the treatments benefited patients.

So what does THAT mean???? What is the Times reporter NOT saying?

My husband went numb with his cancer diagnosis and wanted to stay with this oncologist regardless of what he admitted to us that day. But I was very skeptical when the doctor decided to put 5 different chemos into my husband — who was gone after only two rounds of the toxic drugs.

bOObs Bottom Line:  If faced with a decision of taking chemotherapy, make sure you know all the side-effects of all of them and make sure that you need them all.

Blog at you soon, thanks for reading and helping to spread the word!  (Please see the “share” links below.)  And we’d love to hear comments from you! (see below as well)

Stay healthy,

Megan

Megan Smith, M.S.
Director, bOObs: The War on Women’s Breasts

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DISCLAIMER:  THIS BLOG DOES NOT PROVIDE MEDICAL ADVICE. I am not, nor am I holding myself out to be, a doctor/physician, nurse, physician’s assistant, advanced practice nurse, or any other medical professional.  The statements on this blog reflect the author’s personal opinions.  The content of this blog is for general informational and educational purposes only and is not intended as, nor should it be considered a substitute for, professional medical advice.  The information presented is not intended to replace or substitute for professional medical advice or care, should not be used for diagnosing or treating a health problem or disease, and is not intended for diagnostic or treatment purposes, prescribing any medication, or for use in diagnosis or treatment of any medical or health condition. You should consult your doctor for medical advice or services. Never disregard professional medical advice or delay in seeking it because of something you have seen or read on this blog.


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