WASHINGTON — Doctors who have a financial interest in radiation treatment centers are much more likely to prescribe such treatment for prostate cancer, congressional investigators say in a new report.
The investigators, from the Government Accountability Office, said that Medicare patients were often unaware that their doctors stood to profit from the use of radiation therapy. Alternative treatments might be equally effective and are less expensive, for Medicare and for beneficiaries, the report said.
In other recent studies, the investigators found a similar pattern when doctors owned labs and imaging centers for CT scans and MRIs.
The latest study focused on a common and costly treatment for prostate cancer known as intensity-modulated radiation therapy, which directs beams of radiation at tumors. In many cases, the report said, doctors who recommend the treatment have financial relationships with those who provide it. For example, a group of urologists may own radiation therapy equipment that is used by other doctors in the same medical group to treat patients.
James Cosgrove of the GAO said “financial incentives” appeared to be contributing to the higher use of this type of radiation therapy. Urologists “referred a substantially higher percentage of their prostate cancer patients” to radiation therapy when the doctors owned the equipment or had financial ties to those who provided the treatment, the report said.
The report arrives as Congress is looking for ways to save money in Medicare and to overhaul the way the program pays doctors.
“When you look at the numbers in this report, you start to wonder where health care stops and profiteering begins,” said Sen. Max Baucus, D- Mont, chairman of the Finance Committee. “We have a law on the books designed to prevent these conflicts of interest, but an increasing number of physicians are skirting the law for personal gain.”
The investigators said Medicare had no easy way to know when doctors had such conflicts of interest. Doctors, they said, should be required to note such relationships on the claims they file. The Obama administration disagreed, calling such a rule too complex to administer.
Some doctors disputed the report. Dr. Deepak Kapoor, president of the Large Urology Group Practice Association, said the GAO “greatly overstated the role of financial motives in treatment decisions and understated the importance of patients' wanting to have their treatment in the offices of doctors who specialize in prostate cancer.”