Later On

A blog written for those whose interests more or less match mine.

The Norman Rockwell idea of a physician is fading fast

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Gina Kolata reports in the NY Times:

A well-to-do cancer patient is nearing the end of her treatments. During an office visit, she says to her doctor, “I can’t thank you enough for the care you provided.”

Should the doctor simply accept the patient’s gratitude — or gently suggest a way for her to show it: “Perhaps you might consider making a donation?”

More and more these days, development offices at major cancer centers are teaching doctors to seize such opportunities to raise money for the medical center or for their own research.

In an unprecedented survey of more than 400 oncologists at 40 leading cancer centers, nearly half said they had been taught to identify wealthy patients who might be prospective donors. A third had been asked to directly solicit donations — and half of them refused. Three percent had been promised payments if a patient donated.

The study, which was published online Monday in The Journal of Clinical Oncology, was conducted by Dr. Reshma Jagsi, a radiation oncologist and ethicist at the University of Michigan, who had grown concerned about the practice and wanted to know more.

Dr. Jagsi said she had sat in on workshops, seminars, training sessions and department meetings that discussed how to identify good prospects for gifts, how to direct grateful patients to the development office, and how to ask them directly if they wanted to donate.

She was uncomfortable with the idea, but she also knew some patients want to donate and are grateful for guidance on how to do it. And she knew medical centers needed money now more than ever. What was the ethical way for doctors to help, she wondered? Or should they stay out of the donation business completely?

She searched the medical literature for studies on the subject and found pretty much nothing, so she decided to conduct her own research.

The issue is “extraordinarily important,” said Arthur L. Caplan, head of the division of medical ethics at NYU Langone Medical Center, adding that he had never seen a paper that examined the issues as thoroughly as Dr. Jagsi’s. “Hopefully, this paper will start a long overdue discussion,” he said.

He ticked off some ethical pitfalls: . . .

Continue reading.

Written by LeisureGuy

28 September 2015 at 5:36 pm

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