The Search for Greener Grass: The Second Opinion in a Far Away City

You drive down a busy expressway amidst thousands of other vehicles and a billboard jumps out at you.  In the font of confidence, it reads, ""The first step in fighting cancer should be a second opinion."  The billboard informs you of the location of the nearest Cancer Treatment Center of America (CTCA), "only" about 130 miles from the billboard. When I saw this billboard, my initial response was to recall a recent article about CTCA which challenged their dubious centerpiece claim: Patients with cancer who receive treatment there survive longer than those who don't.  The article pointed out significant selection bias in CTCA's data.  Could individual patients have outcomes comparable to any other cancer center? If the center uses best practices in oncology (including appropriate provision of palliative care), then I have no doubt that some patients have a good experience at the center.  Even though, several patients or their relatives have asked me about the center, none of them have been evaluated or received treatment at CTCA.  At least a few of these patients (or a family member) have gone as far as calling CTCA but haven't gone any further. Enter a salient point about my practice: I work at a safety net hospital where many patients either have Medicaid or no insurance.  They will never receive care at CTCA for this reason.  But they'll still see the billboards and hear the ads on TV or radio.  Patients in a safety net settin...
Source: Pallimed: A Hospice and Palliative Medicine Blog - Category: Palliative Carer Workers Authors: Source Type: blogs