Cancer discussed on Coast to Coast AM with George Noory
Learning together my name is doctor later man I'm a cancer doctor could say why the heck do I wanna listen to a cancer doctor talk about cancer patients well number one it's interesting to know what's going on in the world number two you might learn enough medicines so that you don't get some bad recommendations for some recommendations that you don't really want you don't want to be a pasion with buyer's remorse and add unnecessary surgery on your nose or ear or face or breast or longer pancreas or liver bladder or prostate or colon you probably want to get the best possible care and so often as you'll see in the next few minutes many patients go to bigger hospitals they don't necessarily learn about all the options why not I went to medical school to help people I went to medical school not to so chemo not to push drugs not to do unnecessary surgery but to do the right thing and help each patient that I could and that's what I do and that's what you'll see in the next few minutes he should get a paper and pencil and why because of the a lot of things you want to write down during the show I can promise you that they'll be a lot of things I think you want to write down let's say that and so gonna jump right in the world chance to talk together whenever you want my name is Dr Lieberman I want to talk about an article you should talk just about patience but there's an article in this article was in the New England journal of medicine which is the most prestigious medical journal in America and then there was the synopsis in the Wall Street journal so two prominent articles one by Melanie Evans was published in the Wall Street journal and it's entitled hospitals merged quality didn't improve with the subtitle of the quality of care in hospitals acquired during the recent wave of dealmaking got worse or stay the same new research found well how does that affect you know so often I see patients every day I see patients and I see patients I went to X. Y. super duper pooper scooper hospital as if that was the seal that everything took took place there was so fantastic well we know about that because you talk about that every day and then there's certain small hospitals let's say X. Y. C. hospitals it is X. Y. Z. hospitals are taken over by the super duper hospitals a super duper all schools put their name on it so as of X. Y. Z. so I was super duper hospital over that name is and you know what I'm talking about super duper hospital now all right over the New York area the fact all over United States the big hospitals are buying out the little hospitals and they're raising the rates the rates used to be proportional to the size of the complex in the hospital well if super duper hospital buys a little hospital they may raise the rates doubled or tripled over a beat much much higher and the question is does the care get fatter when super duper hospital buys a little hospital remember a lot of the smaller hospitals or community hospitals that are run in the community by people that you would know that community and they try their best to give care and they have their limitations of course all hospitals to because hospitals are very complex and are not very efficient at giving medical care trying to get a picture with me or a cat scanner cat scan or MRI we can usually range in minutes and you'll have your results in minutes you have the disk in your hand you have the report but high quality best in New York places while you're done Osborne often takes weeks or longer time and then you go looking for the reporter the desk in the Kuwait more weeks it's in a fish in the hospitals are in the fishing vessel out the simply lined it's very in addition and very costly and very noisy well this whole article talks about this quality get better when the super duper hospital buys a little hospitals and she writes Melanie Evans writes in the Wall Street journal this is from an article from New England journal of medicine quote the quality of care hospitals acquired during a recent wave of deal making gets worse new research finds a blow to the frequently cited rationale for tie ups yeah the big houses they were gonna buy little hospital maker so fantastic well the facts are when they look at the quality of care it doesn't get better or gets worse because all of a sudden instead of having a local person running the hospital they have someone in the distance site running it and obviously they're looking for one thing which may be profits so not necessarily to raise the quality and she goes on to say that hospital mergers and acquisition activity have surged in recent years we know that if you look around New York so many of the hospitals and bought out by one or two or three of the big boys and they say well we're buying the hospital quote and she writes quote the greater size will boost quality with new investments in your other improvements as deal makers benefit from each other's strengths well the new research published in New England journal says just the opposite they look for evidence of quality win big hospitals took over a little hospitals and they measured performance of two hundred and fifty hospitals taking over the deals between two thousand nine two thousand thirteen I live in Syria there was no improvement the analysis did not find the improvement that was promised yes Basel said we're gonna take over the laws but also gets better well didn't get battered and very likely got worse and the Harvard researcher Nancy below said the lead author said quality didn't improve quality didn't improve and that was the Adam line and there's harms and Kate bond often associate professor at Stanford so the experts have questioned the benefit of deals without knowing enough about providing answers but she says this woman Kate a professor of health policy at Stanford says we know that acquisitions we know they have harms with the big house will take over the hospitals they have harms the prices go up we don't know what's happened to quality well now we know what's happening to quality in this analysis that were for measures of performance collected by Medicare patient satisfaction deaths within a month of entering the hospital were turn trips to the hospital within a month of leaving and how often heart the Monia and surgery patients get the care that's recommended so four important points again they are patient satisfaction dying within a month of going to the hospital needing to return to the hospital within a month or not getting the care that was recommended and they looked at hospitals that were required three years before and four years after being acquired in the compared the findings to other hospitals they found that patient satisfaction were sent through their own winter X. Y. Z. hospital so famous of sound mind blah blah blah patient satisfaction worsens whoa and the drop in satisfaction was concentrating in the hospital stepped up fire choirs also that have low satisfaction and well when the hospitals are all being taken over by a few big boys there's not so much competition and result so much competition sometimes people don't work their best and we know here it registered in New York we know there's competition for cancer care we know that all the big boys wanna give chemo and surgery and standard radiation we know that we see that every day and we ask what's appropriate and we think the appropriate thing is to tell the truth and not take money from the pharmaceutical companies that take kickbacks from the surgeons or the president of the hospitals to do certain things not we don't do any of those things you don't take kickbacks from the press of a hospital we don't take money for the drug companies from the pharmaceutical industry is wrong go on trips and boondoggles no because here at Radio City New York we have one boss and that's you and it's a low cost endeavor and we know that A. R. P. said if you want the best value in radiology go to an independent radiology center we know that and we know sometimes it costs in big hospitals are ten times more and we know with cancer care often people truly go bankrupt because the costs are so high chemotherapy is often ten thousand dollars a month if you have a co pay you.