Using Research to Guide Quality and Quantity of Care

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I feel fairly strongly that it has changed the equation. I think patients need to know choices. There’s been a big movement, of course, to get patients involved in decision- making, more than the old paternal type of the doctor tells you what to do. Many patients want to get involved. I know doctors, for instance, who won’t order a test or won’t prescribe a line of therapy because they think the patient can’t afford it. My feeling is that the patient ought to be given options. If they decide not to spend the money, that’s fine, but to have the dialogue with some patients is very reasonable. There are still going to be others that, probably, don’t want to get into a discussion about it, will feel that whatever the doctor says is what I’m going to do. In a growing percentage of patients, I think, having a frank discussion about not only the benefits of treatment but the potential costs, both side effect and financial, to the degree that it can happen, is something that should happen.

Oncologists should take advantage of the best guidance available from the research that’s being conducted by the industry and by other clinicians.

That should feature all the relevant outcomes. It should take into account the issues related to patient benefits, quality of life, and relevant information about the service impact, and the even wider societal benefit in sort of a value?based assessment approach.

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