Dr. Otis Brawley: ‘The System Really Is Not Failing … Failure Is The System’ – Kaiser Health News

Further to the interview I posted with Dr. Brawley (here), a more fulsome speech by him with some very concrete examples of how business drivers get in the way of good health care. My favourite:

This [hospital marketing] guy explained to me how if his hospital announced they were going to do free prostate cancer screening in six weeks at a particular mall, and they would screen the first 1,000 men who rolled up their sleeve and said ‘please screen me’ – men over 50. He explained to me how much free publicity they would get off of that announcement. And how much increased business their chest pain center would get off that announcement. How much increased business their breast screening service, their women’s center would get off that announcement

If they screen 1,000 men, they’ll have 145 abnormal. They’re going to charge about $3,000 to figure out why each of the 145 abnormals is abnormal and that’s how they charge for the free screening.

Now with this mall about 10 of that 145 won’t come to this hospital … Now the 135 that they have, 45 will die of prostate cancer and the other percentage they’re going to get radical prostatectomy at about $30,000 to $40,000 per case. With a percentage they’re going to get [radioactive] seeds and about $30,000 a case. IMRT radiation therapy at the time was about $60,000 to $70,000.

And then his business plan goes further. He knew how many guys are going to have so much incontinence that diapers don’t do it so he had in his business plan how many artificial sphincters the urologists were going to implant. And then he was a little apologetic because there is this new thing called Viagra on the market and that screwed up his estimate about how many penile implants he was going to sell because of guys who were upset about impotence due to prostate cancer treatment.

This is 1998. [I said] if you screen 1,000 people how many lives are you going to save. He took his glasses off, looked at me like I was fool and he said ‘Don’t you know nobody has ever shown that prostate cancer screening saves lives. I can’t give you an estimate on that.’

Dr. Otis Brawley: ‘The System Really Is Not Failing … Failure Is The System’ – Kaiser Health News.

Advertisements

What do you think?

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s