Financial gain is driving referrals for specialist prostate radiotherapy, says report

BMJ 2013; 347 doi: (Published 08 August 2013) Cite this as: BMJ 2013;347:f4978
  1. Michael McCarthy
  1. 1Seattle

The financial interests of doctors and not clinical need are driving up the use of intensity modulated radiation therapy (IMRT) for treating prostate cancer, says a new report by the US Government Accountability Office (GAO).1

Major urological groups in the United States immediately denounced the report, calling it “a flawed, misleading study,” while the American Society for Therapeutic Radiology and Oncology, ASTRO, called it a “striking report” that “details clear mistreatment of patients who trusted their physicians to care for their prostate cancer.”

In the study investigators from the accountability office looked at the referral patterns of practices caring for Medicare patients with prostate cancer. They compared the referral patterns of practices that had no financial stake in an IMRT service, called “non-self referrers,” with those that did have a financial interest, called “self referrers.”

IMRT is a form of external beam radiation treatment in which the radiation beams are shaped to maximize the amount of radiation the tumor receives while reducing the amount to which normal tissue is exposed.

The treatment is substantially …

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