I’d bet if you took a survey in the US, you’d find most people are pretty happy with their current health care provider(s). Let’s face it, most people aren’t sick, and even when they do get sick, their own immune systems can fix most anything on its own. For most other ailments a visit to a primary care physician can easily diagnose and prescribe the necessary action to resolve the matter quickly.

So why do we even try to rate health care providers? I for one have never been a fan of health care provider ratings, because it can’t be done reliably. Health care is not an exact science. It is an art [of sorts], and trying to apply statistical measures to it are at best suspect.

Even trying to track the things that could be measured objectively, such as in patient infection rates, readmissions, etc. can’t be relied upon, because in a for-profit health care system, absent of regulation (like in the US), the incentive is to skew the data to produce positive results. And you sure can’t rely on data supplied by patients either, because most people aren’t knowledgeable enough about medicine, and are subject to personal prejudices.

Still that doesn’t stop people from trying. There’s a new website being developed by a multiple myeloma survivor, attempting to present data comparing survival rates of multiple myeloma patients by doctors, hospitals and regions in order to quantify the best in each category.

Despite the well intentioned efforts I’m sure this person has, I can’t help but ask myself why bother?

Certainly this information might be useful, but like I outlined above, you just can’t rely on the integrity of the data, especially, as in this case, when the data is being supplied directly by the doctors and hospitals being rated.

And even if you could rationalize the integrity of the data in this instance, the number of variables that exist [and not included] are endless, and difficult, if not impossible, to quantify.

For example, how far along has the disease progressed in a particular patient? How do we know if the health care providers, with the worst survival rates, weren’t just being inundated with the worst and most difficult cases? Identifying those health care providers as poor performers would not only be doing a disservice to the health care providers, but also to the patients who might steer clear of them.

And how do you quantify the aggressiveness of a disease? One thing I’ve learned throughout all this is, while there may only be one disease, there are numerous variants of each, some aggressive, and some not so agressive. Even if the doctors and hospitals were able to run all the tests necessary to categorize the aggressiveness of a disease (a cost which incidentally would be exorbitant), one has to keep in mind we are all different, and in any number of cases, those with poor prognostic indicators can perform extremely well, while those with good prognostic indicators can perform poorly.

Then there’s age to consider. How do you factor that into account? Are all 60 year olds in the same physical condition?

Just look at Joe Paterno. He died extremely quick after we first learned of his diagnosis. Do we really think he wasn’t receiving the best care? Should the hospital and doctor be penalized for that?

While I applaud the effort, simply because anything that keeps cancer survivors occupied, and not constantly worrying about their fate, has to be beneficial, I would be extremely skeptical of any of the ratings provided by this website, or any similar ones.

Posting on how to be better, more informed and proactive patients (one of the original goals of this blog), in my opinion, would be time better spent.

The only way to be sure we’re receiving the best possible care is to be knowledgeable of our disease. We’re not all blessed with being able to see a hematologist/oncologist that focuses solely on our particular disease, so asking the right questions, and supplying your doctor(s) with up to date information is absolutely vital.

Doctors are only human. They see many patients, all presenting differently. It would be naive to think any hematologist/oncologists has the ability to keep up with all the advances in the treatment of the myriad of cancers they deal with on a daily basis.

Staying informed and helping your doctor by supplying him/her with the latest information regarding your disease is something I have found every doctor I have had contact with to be very grateful for.

All you really need to know is, a proactive patient is a good patient, and the one who will likely survive the longest!

Post to Twitter

 

Can it really be called a downside?

According to Joseph M. Connors, MD, Clinical Professor and Director of the BC Cancer Agency’s Centre for Lymphoid Cancer, Vancouver, British Columbia, in an article in the ASCO Post, the downside to Canadian health care is

We [the Canadian health care system] don’t get to give patients treatments unless they have proven benefit, so we have an entire system devoted to examining what evidence justifies which treatments…….

……….I [Dr. Conners] cannot give a drug without evidence-based proof that the drug has efficacy and works better than the less-costly alternatives in the particular disease I’m treating. So the drawback to a centralized system is that it constrains innovative behavior, is resistant to change, and is slow to introduce new approaches. The system waits for adequate evidence before moving ahead…….

Well, I’m not so sure I’d categorize that as a downside, and neither do I believe it constrains innovation.

Just because something is new, and may have shown efficacy in a petri dish, or even in a stage 1 trial, doesn’t necessarily mean it will be effective when given to humans. And let’s not forget about potential side effects of rushing treatments to market. You only have to look at drugs such as Thalidomide, and more recently Avastin, to recognize the flaw in that thinking.

And besides, isn’t that what clinical trials are for? Something else Canadians and Europeans have far greater access to than those in the US, that is unless you

have adequate coverage or can pay out of pocket

But then again, why would you invest in a costly clinical trial, with an uncertain outcome, if off label use is making you money?

I don’t know about everyone else, but if that’s the only downside to Canadian health care, I’m willing to take my chances!

Post to Twitter

 

I was thinking last night (I do that whenever I have trouble sleeping), and I’ve come to the realization, in the nearly 10 years since my diagnosis with MCL (when I was personally awoken to the issue of cancer), there has been a lot of research done, and too many to fathom clinical trials performed, yet there has been very little [monumental] advancement in the way we deal with and treat cancer.

We’ve managed to map the entire human genome. We’ve even come close to discovering the causes of [at least one] cancer, yet there is still no cure, and our approach to treating cancer remains, as it has been for the past 50+ years, to do nothing more than infuse deadly chemicals into the body, in hopes of destroying the cancerous cells. Even one of the biggest advances recently in the treatment of lymphoma, has been the reemergence of Bendamustine, an alkylating agent developed in East Germany in the 1960′s.

Yeah, there have been strides made in the use of stem cell transplantation (SCT), and there have even been some new blockbuster drugs that have come on to the market, e.g. Rituxan, Gleevic and Velcade, but they have done little, aside from maybe delaying the inevitable for a few more years, to advance a cure. And even those approaches have their limitations, especially in the case of SCT’s, which can produce debilitating side effects, i.e. graft vs host disease (GVHD), that in some cases may be worse than the disease.

You’d just think after all these years, with all the great minds and other resources available in this country, and around the world, there would have been greater strides made towards finding a cure for cancer, or at the very least develop new and safer drugs for the treatment of cancer.

What’s even more depressing is with the political upheaval in the US, it appears further advancements related to all types of health issues will be greatly hindered. There are already critical drug shortages showing up around the country, and expected cuts to funding for the National Institute of Health (NIH), portend few [if any] advancements for the foreseeable future.

The principle reason I’ve delayed treatment so long has been the hope something better would come along, but it seems I’m going to have to wait just a little [a lot] longer.

Post to Twitter

 

No, that isn’t a mistake in the title. Because of my enlarged spleen (which can get in the way of the scope), and the potential problems as a result of that, my doctor has obliged my request for a colonography in lieu of the standard colonoscopy.

The only advantage to a colonography being, I won’t have to endure the torture of having someone stick a 10 foot probe up my butt.  I still have to go through the standard cleansing process (the second most difficult part of this entire ordeal), plus if anything is discovered during the colonography, I may still have to go through the torture of a standard colonoscopy anyways.

The other problem with the colonography is I will be exposed to radiation from the CT scanning machine, which is how a colonography is performed, and all the problems associated with that. At least I’ve not been exposed to much artificial radiation in the past 8 years, having had only one CT scan, and I think one X-ray, during that time frame.

So as I sit here writing this post, not going for a bike ride, and pondering [dreading] the start of the cleansing process (which begins at 10 AM), I’m wondering if it’s even worth it. Do I really want to know if I’m any sicker than I already am?

Post to Twitter

 

Admittedly it’s taken me 63+ years, but after reading James Altucher’s latest blog post, I’ve become enlightened.

Everything we’ve ever been taught, or told, our entire belief system, has been designed with one thing in mind, and that is to control our every action. It used to be religion was the only control mechanism (at least so I thought), but now that isn’t enough. It’s gone way beyond that.

From the idea of home ownership and raising a family, to the necessity of getting an education. Even the design of our health care system has all been designed for one purpose, and that is to change the way we think, and inevitably control our very being and every action.

It was L Ron Hubbard who said,

If you really want to enslave people, tell them you are going to give them total freedom

Think about it. Why is so much emphasize placed on the notion of getting a job, buying a home [with a big mortgage], raising a family, and building roots in a community? It’s simple, because once we do, “they” have us by the balls, so to speak. We’re no longer free to pursue the so called “American Dream”. We’re inextricably coupled to our homes and families. We can’t move, because we’ve literally established roots.

Even our health care system has been designed with that same purpose in mind. To control us!

I’ve often wondered why businesses don’t object to being burdened with the responsibility of insuring the health care of their employees, rather than having that responsibility dumped on the government. It certainly would increase profits. Or would it?

By tying health care to employment, employers have made it more difficult for employees to strike out on their own and compete [to pursue that "American Dream"], or even change jobs, because obtaining health insurance is either too expensive, or simply unobtainable for many due to pre-existing or chronic health problems. The current system allows employers to have greater control and influence over their employees, and artificially keeping wages down, by creating an immobile work force.

It’s a conspiracy on a grand scale, and the American public has fallen for it, hook, line and sinker.

Post to Twitter

 

Mark Twain said:

Truth is stranger than fiction, but it is because Fiction is obliged to stick to possibilities; Truth isn’t.

While many may label this as fiction, and I will admit it may be somewhat exaggerated, it’s certainly not far off the mark, and definitely the direction health care is heading in the US. (I think Monty Python might just have been a little ahead of their time.)

And yes I know I said I was taking a break from blogging, but I did say I would post things I thought were worth sharing. I was just of the thought this Monty Python skit (as well as the Albert Schweitzer quote) was definitely worth sharing.

Post to Twitter

© 2011 Living with MCL Suffusion theme by Sayontan Sinha