The Doctor Will Negotiate With You Now.

Not all prostate cancers are created equal.  Some are high-grade and life-threatening.  These tumors need to be addressed promptly and aggressively.  Many prostate cancer tumors, however, are slow growing and may never need to be actively treated.  For these low-grade tumors, watchful waiting is the best course. Watchful waiting is a good alternative for these tumors because all of the major treatment options for prostate cancer are likely to leave patients impotent or incontinent or both.

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There are great societal pressures in favor of aggressive responses to cancer.  Family and friends urge the newly diagnosed patient to have the cancer cut out.  The cancer doctor who suggests watchful waiting may be a lone voice crying out in the wilderness.

Dr. Behfar Ehdaie at Memorial Sloan Kettering Cancer Center in New York City was disappointed that many of his patients for whom he counseled watchful waiting were opting instead for definitive treatment with all its attendant risks.  He and a colleague began a search for ways to encourage watchful waiting among patients for whom it was the best choice.  Their search, which is the subject of a story in last week’s Wall Street Journal, led them to the Harvard Business School and a professor there who specialized in teaching negotiation tactics.  The conclusion was that physician advice to patients was indeed a form of negotiation and that the adoption of successful negotiating tactics might lead to patients making better treatment choices.

Dr. Ehdaie embraced the advice and began discussing watchful waiting as the first treatment option and emphasizing the rigorous nature of the observation.  The changes were effective and most of Dr. Ehdaie’s patients began to accept watchful waiting as their “treatment” of choice.  The program has since been expanded to other surgeons with similar results.

Congratulations to Dr. Ehdaie and his colleagues for innovative thinking that will both save money and improve patient outcomes.

 

Posted in Cancer, Doctors, Health Care Costs, Medical Costs, medical ethics, Prostate Cancer, prostate cancer testing |