Destructive Incentives

Kristen Sparrow • December 28, 2012


woman doctor
Who do you trust for information?

Two articles, one from the SF chronicle and one from the NY Times. Both underscore the problem with a purely market based health model. The Chronicle article discusses a study which exposes the increase in cancer recurrences because patients were given substitute chemotherapy because of shortages in the drugs required by protocol.  Why?  Shortages occur because the protocol drugs are “off patent” and so not lucrative for the parent company.   The Times article discusses the unprecedented move by the AMA to caution physicians to put patients first and not be swayed by monetary pressures from the hospitals that employ them.  Not encouraging, since we always know that “the invisible hand of the market” doesn’t look out for the general welfare.
“A drug given to lymphoma patients as a substitute for a chemotherapy medication that is in short supply has been linked in a study to an early recurrence of the cancer, according to a report released Wednesday that provides the first actual evidence of patient harm caused by a national shortage of drugs.The shortage specifically includes older, generic medications needed for a wide range of uses such as cancer, surgery and pain management, say authors of the report, which involved Stanford University School of Medicine and Lucile Packard Children’s Hospital in Palo Alto.”
December 26, 2012
Doctors Warned on ‘Divided Loyalty’
WASHINGTON — With hospitals buying up medical practices around the country and seeking to make the most of their investment, the American Medical Association reached out to doctors this week to remind them that patient welfare must always come first and not be overridden by the economic interests of hospitals that now employ doctors in ever-growing numbers.
“In any situation where the economic or other interests of the employer are in conflict with patient welfare, patient welfare must take priority,” says a policy statement adopted by the association.
“A physician’s paramount responsibility is to his or her patients,” the association said. At the same time, it added, a doctor “owes a duty of loyalty to his or her employer,” and “this divided loyalty can create conflicts of interest, such as financial incentives to over- or under-treat patients.”