Is the fee for service payment system affecting oncology practice and cancer patients?

Paying doctors to do more isn’t in a cancer patient’s best interest.

An oncologist pens a brutally frank letter discussing how the current fee for service system influences the decisions when administering chemotherapy.

Currently, up to 70 percent of a cancer doctor’s earnings come from the sale of chemotherapy drugs. There is a strong financial incentive from “doing more,” and doctors are not immune to this allure. The result is a pressure to either adjust the dosing schedule, or start regimens on inappropriate patients, in order to maximize revenue.

Oncologist Peter Eisenberg concurs, by saying, “We are paid more for administering the drugs than we were in the past, so it makes economic sense to administer them more often. Not every doctor is willing to do that. The practices that shows some restraint and don’t treat everyone who walks through the door with chemo are the ones that are suffering.”

The situation will only worsen as Medicare constantly threatens to cut physician payments, including those to oncologists. This will add further incentive to alter chemotherapy regimens, and it is questionable whether some oncologists can resist this pressure.

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