US doctors owning radiation facilities: conflict of interest

Gov’t report: Doctors with financial interests order more radiation Doctors who invest in radiation treatments and centers are more likely to prescribe it to their prostate cancer patients, a government report finds. CBS NEWS/ MICHELLE CASTILLO / August 19, 2013,

The U.S. Government Accountability Office said that most Medicare patients with prostate cancer who went to doctors with a vested interest were not made privy to the fact that there were alternative options to radiation therapy. Many of these other treatments were less expensive and may have been just as effective.

“We are extremely concerned that many older male patients are receiving such vigorous, possibly unnecessary treatment by urology groups,” Dr. Michael L. Steinberg, the chairman of the American Society for Radiation Oncology, said in astatement. “Clearly, these self-referring urology groups are steering patients to the most lucrative treatment they offer, depriving them of their full range of treatment choices, including potentially no treatment at all.”

Doctors who had a monetary stake in radiation treatment included those who invested in a treatment center or doctors who owned radiation therapy equipment that they shared with others in a medical group.

Between 2006 and 2010 the number of intensity-modulated radiation therapy (IMRT) procedures billed by self-referring medical organizations rose from 80,000 to 366,000 — an increase of 456 percent. IMRT involves using radiation beams to reshape a tumor in order to avoid touching healthy areas and to limit side effects, the Mayo Clinic explained. In contrast, the number of IMRT procedures billed by non-self-referring medical professionals went down 5 percent in the same time period.

IMRT spending by doctors who referred patients to their own centers or used their own equipment went up $138 million, compared to non-self-referral groups which just increased their spending by $91 million.

Urologists who were financially involved in radiation treatments advised 38 percent of their patients in 2007 to undergo the treatments. By 2008 to 2009, that number was as high as 54 percent.

In 2009, doctors with a vested interest were more 53 percent more likely to refer their patients to undergo radiation compared to other procedures like radical prostatectomy (removal of the prostate) or brachytherapy (radiotherapy where radiation is placed inside or next to the treatment area). Brachytherapy typically causes fewer side effects and has shorter overall treatment time compared to IMRT because it allows doctors to deliver more specific, higher doses of radiation to affected areas, the Mayo Clinic pointed out…….

“Unfortunately, when you look at the numbers in this report, you start to wonder where health care stops and where profiteering begins,” said Senate Finance Committee Chairman Max Baucus, D-Mont., in a statement. “Enough is enough. Congress needs to close this loophole and fix the problem.”……http://www.cbsnews.com/8301-204_162-57599131/govt-report-doctors-with-financial-interests-order-more-radiation/