Texas Conservative News

From the Tip Line: One cancer survivor’s experience with health care reform:

Taking Charge of Our Own Healthcare
By Keith Friend, Fort Worth, TX

 

At a time in my life when most are thinking of their family’s future relating to kids going to college, weddings and maybe even future grandkids, I was hit with a very different future, or even no future at all. At the age of 41, I had been diagnosed with Stage IV colon cancer.

 

After my diagnosis, I went home – my mind still racing – to find a haunting statistic: the 5-year mortality rate for patients with this stage of colon cancer is 92 percent. Determined to be part of the eight percent, I have worked closely with my doctors. And thanks to the innovative treatments that are currently available, more than 115 chemo treatments and 4 ½ years later, I am happy to be alive. Since I have been so fortunate, I have become dedicated to being an advocate for other patients who might be going through the similar experiences.

 

In the U.S., we have always valued the need to both develop new medications for patients and give physicians access to the information that will help them better treat their patients. We know that decisions about the best course of action for each individual patient are something that must be decided between the patient and his physician. Taking a “one-size-fits all” approach to medicine would not have worked for treating my cancer.

 

And it will not work for other patients either.

 

It is important to remember that every body is different. Unfortunately, the U.S. Department of Health and Human Services (HHS) has begun taking steps that lead me to worry that there is work being done that will interfere with the patient-physician relationship. The sacred nature of this relationship – and the results it provides – is why I can write this column today.

 

For example, HHS has begun a $30 million pilot project to establish a “government detailing” program. This program calls for government contractors to visit individual physicians and encourage them to change their prescribing decisions based on comparative effectiveness research (CER) study results.

 

While it may sound like a harmless, if not positive, approach towards giving physicians access to more information to make better decisions, the patient community should be concerned with where this new program could lead. Three things make me worry about this program – it isn’t transparent, it involves the government trying to cut costs, and it relies on judgments about how doctors should change their treatment recommendations.

 

These new “government detailing” programs could interfere with the doctor/patient relationship by pressuring physicians to follow recommendations based on broad population averages that do not reflect the differences of individual patients. Because every patient is different, CER results that detailers recommend may not be in the best interest of a specific patient. It would be hard to find someone who is against sharing the latest medical research. I am concerned, however, that the government’s contractors might use CER results to interfere in the relationship between my doctors and me.

 

In addition to encouraging doctors to use the latest CER results, government detailers will also be urging doctor’s offices to implement U.S. Preventative Services Task Force recommendations. Unfortunately many of these recommendations have been criticized by members of the patient community.

 

In 2009, the Task Force received overwhelming pushback when they recommended that mammography screening for average-risk women under forty was unnecessary. They concluded that the benefits did not outweigh the downfalls of screening, which included stress that can be caused by false-positive results and the need for further testing. Given my experience, I can say without reservation that some stress is well worth being alive!

 

In fact, the recommendations were rejected by the American Cancer Society and caused an uproar among patients, particularly breast cancer survivors, who attribute routine mammogram screenings to saving their lives. While not the case for all Task Force recommendations, there are serious dangers of pressuring a doctor’s office to follow their recommendations.

 

If my team of doctors had taken that one-size-fits all approach for me, I think I would be part of that 92 percent statistic I mentioned earlier. Every time I have a re-occurrence, I consult my medical team and, through them, I receive expert opinions to make my decision. A standard treatment or cookie-cutter approach for colon cancer would not have worked for me. Simply, I need to be in charge of my healthcare, not government detailers.

 

With healthcare reform, it is not easy to be aware of how every component of the new law will affect us. But when the government begins visiting our doctor’s office and tells them how to treat us, we should all take caution. After all, patients’ lives are at risk.

 

Keith Friend is a 5th generation Native Texan. In June of 2008, he was diagnosed with Stage 4 colon cancer and is looking forward to celebrating the 5th anniversary of this diagnosis this summer.