How thorough are you when making a major purchase or engaging a key contractor or financial professional?
Do you view one house, check out one car, get a single bid, investigate only one investment advisor? I hope not.
Just as you carefully examine and evaluate all life-changing and bank-account-impacting situations, the same vetting process and due diligence must be applied to your long-term survival; every decision made in a direct, businesslike manner.
My Cancer, My Life, My Approach
Recently, a reader of my book, n of 1, wrote that she was struck by how businesslike my approach was to my challenge with cancer—my personal actions were proactive, and deliberate, and measured, complete with expectations regarding what I was paying for.
Her note gave me pause. I hadn’t really thought about it in such stark terms. But she was right. I did have, and do have, expectations for and from my health service providers—including my physicians and oncologists—and the products I purchase to support my overall health.
Commerce and Cancer
The global business of cancer is enormous and complex. It’s a machine well positioned to capitalize on the environment of disease run amok—managed by clinicians supported by an arsenal of interventions and agents—some effective and some not so much.
In the U.S., with its mix of providers and payers (mostly not socialized medicine) and the annoying spectacle of pharma ads running in print, online, and on television—many featuring expensive cancer drugs—it’s impossible not to see the ever-growing cancer ‘sales and service’ industry.
The Agency for Healthcare Research & Quality estimates that direct medical costs (total of all health care costs) for cancer in the U.S. alone, in 2015, were $80.2 billion.
The stark reality is that—and assuming your care is not fully government-subsidized—you represent a significant piece of business to the clinic or hospital you are considering working with, or have already committed to.
Ensuring a Positive Return on Your Health Investment
The most informed cancer treatment and management decisions come from, well, the most informed clinicians. These are the professionals who go the extra mile of keeping up with the translation of cancer science and then ensuring its value is applied down the line, right to the unique patient who stands before them.
I have a lot of respect for physicians, especially oncologists. I count scores of them as colleagues and close friends. They carry heavy loads; they see an inordinate amount of physical and emotional suffering. It’s not a gig for the thin-skinned. However, most (certainly not all) love what they do and are driven to improve the human condition.
Most oncologists outside academic practice or, otherwise, part of large hospitals, are not super-specialized in one disease. Oncologists primarily depend on NCCN guidelines to recommend treatment plans. Keeping up with newly published oncology studies is virtually impossible, given the vast number of clinical trials that are published each day.
When I was diagnosed with leukemia in 1991, drug ads were not on television, but the cancer industry complex was gaining steam. It was clear to me, at the onset, that I needed to be careful in the decision-making that guided my care. My life depended on it.
Cancer survivor Bob Riter had this to say in his article titled ‘The Art and Science of Oncology’: “Science is the starting point of cancer care, but there is an art to applying that science to each patient. This art is based on clinical experience, judgment, and intuition. Patients don’t always fit into neat little boxes with obvious choices for the best treatment”.
Though the best informed cancer treatment and management decisions may come from well-informed clinicians, it is the well-informed patient—the disease ‘host’, the consumer of these services—who chooses the best complete healing options so that the greatest potential outcomes may take hold.
It is often thought that the best arrows are drawn and delivered from the standard of cancer care quiver. But this may forsake the art of cancer care, in service of following wherever the science may lead, without careful regard to each individual’s needs—without nuance, without exceptions. The bridge is, in fact, the business savvy patient and his or her network.
The Cancer Business Learning Curve
The reality is simple, if not disturbing and disheartening, for the newly diagnosed: cancer care is a confusing, complex, and competitive industry sector. It’s a brand-new experience for someone coming from outside the field. Here, the recently diagnosed, in their lowest emotional state, are thrust into making major health and economic decisions.
Making Powerfully Informed Health ‘Business’ Decisions
Of course you should be respectful of the medical professional participants throughout the process, but never forget that you are the client—the buyer, the patient. Few decisions need to be made immediately; the occasional exception comes into play only when fatal, super-fast spreading disease creates urgency.
You have choices, mostly; though it is dependent upon where you reside, where you are willing to travel and, of course, costs, if you do not live in a country that provides socialized medicine as a right.
We are talking about your health, your life, or that of a loved one. All decision-making should be regarded as a sacred process. In a perfect world, each of us with cancer should simply expect, and receive, the highest quality of care—diagnosis, therapeutic options, long-term survival planning, and counseling, and lifestyle coaching.
But cancer is unpredictable, because each person’s disease is unique to their body’s environment. And this truth makes it even more challenging, from the perspective of a ‘buyer’ (the client or patient), to fully understand what is being purchased and its potential long-term value.
Therefore, every aspect of the cancer journey, the cancer continuum of care, needs to be carefully considered.
- Oncologists and all physicians need to be highly vetted.
- There are no such things as bad questions, just bad answers; you should be comfortable asking as many as you have, unrushed.
- Second and even third opinions need to happen, and engaging an academic clinician-researcher is often critical. If your community oncologist does not respect and support this decision, then you are not seeing the right one.
- Recommendations of treatment options, including clinical trials, need to be weighed.
- Integrative oncology approaches (and providers) should be treated no differently than your conventional oncology team. Carefully consider the benefits, costs, and any potential risks, with a laser focus on lifestyle changes, including:
Your team of physicians, as well as the products and services you engage to support your quality of life and long-term survival, represent critical business decisions that support your health, and affect your finances. So make every purchase—every decision—count.