While the practice of physician self-referral has faced increasing scrutiny nationwide, the proliferation of physician-owned centers offering prostate-cancer patients intensity-modulated radiation therapy (IMRT) has sparked a controversy of its own in Maryland, the Washington Post reports.
According to the Post, the Maryland Board of Physicians ruled last week that radiation therapies such as IMRT are indeed covered by the state's "self-referral" law, which restricts doctors from referring patients to facilities in which they have a financial interest. While the law permits doctors to self-refer patients in cases where it makes sense to quickly diagnose and treat some conditions, critics such as Peter D. Grimm, executive director of the Prostate Cancer Treatment Center in Seattle, say some urologists are taking advantage of the exception.
"I think it's one of the biggest scandals in America today," Grimm told the newspaper, adding, "Do you want your dad going to somebody who has a very highly incentivized reason to give him one particular treatment that is not necessarily in his best interest?"
In the other corner, we have Deepak A. Kapoor, MD, who chairs Access to Integrated Cancer Care, a Washington-based group that his center, Chesapeake Urology, and other urology groups formed in 2009 to represent their interests. Kapoor also heads Integrated Medical Professionals in New York, the largest of these centers. Kapoor and other proponents of IMRT centers argue that financial incentives never influence the care anyone receives--and that their centers exemplify community-based integrated care. Chesapeake patients indicated to the Post that they were fully informed of all treatment choices available to them before selecting IMRT.
Thus, Chesapeake Urology Associates is among the doctors' groups challenging their state's restrictions on physician self-referral in the courts. They also are backing a bill introduced last month in the Maryland General Assembly that would amend the current law, which the Maryland Court of Appeals upheld in January. Paul T. Elder, the board's chairman, says the board has no information about whether any practices in Maryland will have to make changes because of the law. Chesapeake Urology officials said they will look carefully at the board's ruling.
To learn more:
- read the article in the Washington Post