“Cancer!” Should you rush to a “major” cancer center?
The Modern Healthcare article noted “When it comes to cancer care, there is a huge disconnect between the possibilities of modern medicine and its day-to-day practice. As last fall’s troubling report from the Institute of Medicine noted, variation in oncology practice is wide; collection of quality and outcomes data is poor; and progress in learning what works best for any particular cancer remains slow and halting.”
“The ever-shifting medical science makes educating oncologists a daunting endeavor. The failure by some clinicians to adhere to the latest practice guidelines is the main reason why there is so much variation in care across the country. Indeed, setting aside the issue of inadequate access to cancer care because of a lack of insurance or cultural barriers, variation in care delivery is the single largest cause of the uneven results from cancer care.”
“One question that needs answering is whether that variation is greater among oncologists working in a community practice, in a local hospital or a major cancer center such as M.D. Anderson or Memorial Sloan-Kettering. The answer isn’t obvious.”
“The major cancer centers can certainly command a higher price because of their stellar reputations and marketing. But as we have seen in other practice areas such as cardiovascular care, high price and reputation aren’t necessarily correlated with better outcomes.”
“The medical literature is missing solid studies comparing the quality and outcomes of care at competing cancer centers. Moreover, there are many confounding variables. Do the major cancer centers attract healthier patients because they are the ones who can travel? We know that when it comes to surgery, volume matters. Centers that do many surgeries tend to have better outcomes. But does that matter if you’re the low-volume surgeon at a high-volume hospital?”
It is always a good idea to talk to your primary care practitioner, the clinician who knows you best, about the pros and cons of cancer diagnostic and treatment options.
Click here to read the full MHC article “Where should you go for cancer care?” by Merrill Goozner.
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Jonathan M. Metsch, Dr.P.H., is Clinical Professor, Preventive Medicine, Icahn School of Medicine at Mount Sinai; and Adjunct Professor, Baruch College ( C.U.N.Y.), Rutgers School of Public Health, and Rutgers School of Public Affairs and Administration.
This blog shares general information about understanding and navigating the health care system. For specific medical advice about your own problems, issues and options talk to your personal physician.