The URORAD~ bypassing Stark Law and anti-kickback legislation issues (enjoy reading)

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zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 6/12/2011 4:13 PM (GMT -6)   
Interesting article in the latest Paactnewsletter edition you can go read it online at www.paactusa.org (newsletters pdf file tab) June pages 3-5  In effect the morphing of the uro-doc into the uro-rad-doc...a more radical concept of keeping it all in the house.
 
See how some loving urologists whom don't like missing sales and additional cash opportunities are establishing UroRad centers (basically a self referral concept), maybe cornering the market theory (lol). To be legal all you need is a radiation oncologist 'on site', and doesn't have to be board certified or demonstrate any particular advance prostate radiation skill.
One consortium in Texas, UroRad Healthcare, sells packages of IMRT equipment and service to urologists (was in Wall Street Journal). Thus, helping the quest to be fullfilled in finding a little loop hole in the Stark Law so that this practicing can exist without so called conflict of interests or I like to label it more truthfully as 'cashin on patients', after all it is all about fairness and seeing the patient gets the best options, fullness in disclosures, full drug choices, full proceedurial information (I love transparency). So read the article and see what you think, the writer is well known.
 
Medicare snippet on this:  reimbursement for IMRT ($40,000)much higher than surgery (depending on location) and surgery at $7,000 (typically) and $1,500 for brachy seeds.
How interesting, anybody what to look into setting up shop. tongue   Info from article.

142
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Date Joined Jan 2010
Total Posts : 6983
   Posted 6/12/2011 6:07 PM (GMT -6)   
I have mixed reactions to the article.
 
First, it is clear that offering all the options "in house" seems to smack of big business, which I tend to dislike.
 
It is also more than a bit concerning that companies would actually specialize in building the environment. But then it is yet another business.
 
But, I am a bit skeptical of Dr. Dattoli as the author. We know that he has a clinic specializing in radiation therapies, and the literature and books I've seen from his clinic are, in my "patient - reader" opinion, a bit heavy on the wonders of radiation.
 
Where the RT clinic is managed well, impartial, and professionally staffed, I can't see an issue for the patient. Where not, well, that would be a different discussion. But then we can make the same observations about the VA - we have seen widely diverse opinions expressed here about some localities.
 
I will say that my surgery and adjuvant radiation were done in an environment where there was a business relationship between the partners of the urology clinic, the RT clinic, and the major university hospital where I had my surgery. I did do my research, and all of the doctors and facilities involved had the highest ratings from my insurance company, and were well known to the local support groups/foundations I contacted. I had the option of, and did investigate, some large national cancer centers, one of which advised that they would not consider me for their programs (seeds or Proton RT), and others that suggested that the care available in my area was equal to the services they could offer. The issues of time and travel were not manageable with my job and insurance coverage, so local it was.
(Note I was not yet aware of HW when I did all this, so no bashing over not having followed any particular advice, please!)
 
So, overall, a mixed reaction.
DaVinci 10/2009
My adjuvant IGRT journey (2010) -
www.healingwell.com/community/default.aspx?f=35&m=1756808

zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 6/12/2011 6:44 PM (GMT -6)   
I am not supporting one doc against all or againts other surgeons, just another piece of the transparency puzzle for we patients to realize what you are worth as a commodity and how wonderful the hypocratic oath is formost in many minds.

Patients have alot fun playing the games (maybe not so funny). I welcome other transparencies as what goes on in treating patients, especially in the name of cashin. Bashing should be an equal opportunity type thing, I don't call it bashing anyway...I call it the way it is...maybe seeing real transparencies in everything....including drug prices and things we are not conveniently told about and other fun events that you cannot hide from patients forever. I don't mind hearing about any of the players whom are in effect guilty of less than full fairness to the patients and system. Since we are the cash cows, it is kind of fun to know what beautiful things actually go on behind the smiles. We used to be told how definitive our worthless scans are, funny how transparency changed all that!!!

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6983
   Posted 6/12/2011 7:27 PM (GMT -6)   
Zufus - wasn't referring to Doctor bashing - it was a reference to someone who roundly and vocally criticized my treatment choices when I first came on HW, as if I had somehow not considered my plan carefully enough, even though it was well after the fact ...
 
I'm not proposing to bash Dattoli either. If I had been inclined to do RT as a primary treatment, I would have contacted them, as they come highly praised for RT. I have read his books and literature, and see a certain bias, the same one I get from my RO. But no RO gave me a decent prospect of cure, so I dumped the idea as primary treatment.
 
I don't see anything wrong with a multi-functional clinic / practice, IF they are working for the patient's best interest. But I can certainly see room for abuse, and the article does put that in focus.
 
We might also question the big hospitals -
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