My wife celebrates cancer lesson for Health Care

In July 2008, my wife Linda was diagnosed with advanced squamous cell carcinoma of the oral cavity. Further treatment has led me to see the U.S. health care from a different perspective. Linde What I've learned over the past two years has expanded my core beliefs about medicine. In sum, while amazing advances have been made and the miracles that are occurring, medicine remains as much an art.

I have spent almost 40 years in the business side of health care industry, including the last seven as CEO of a health plan. I thought my network serve us well. I figured it had clear answers to questions about the best treatment plan and the best suppliers.

What I learned was that for rare diseases such as Linde, if not all diseases in general, clear answers are often lacking. Never forget a doctor tells me that the information sought was not available and would have to trust my instincts. This is pretty incredible when you think about the quantity and the society we spend on health.

The new federal health care reform promotes the adoption of health technology information and supports comparative effectiveness research to understand the marginal contribution of new drugs, devices and procedures. But what we have learned to treat Linde is that data on innovations, especially for less common diseases, is not sufficient to create an overview of the evidence-based medicine.

Risk Adjustment

Often medical research, even when coordinated and summed across the industry, does not have enough patients with a particular disease to test alternative treatments with scientists - trial and error - methods. I can not tell you how many times I've heard of doctors who each patient is different.

The same deficiency exists for assessing the professional experience of a particular treatment for a disease. To evaluate a doctor or treatment is necessary to adjust for differences in risk in patients. In general, it is more difficult to care for an elderly patient a younger. Similarly, the treatment of patients with diabetes is more difficult than those without. There are thousands of risk factors and standards for them is difficult if not impossible.

This has implications for what we consider the best places to get care and how the medical performance should be reported. We really do not want doctors to avoid the most risky to achieve better grades.

Work in Progress

Faced with these limitations, clinicians often rely on their understanding of the underlying disease process to decide the best course of action. Major medical organizations convene panels of experts to provide opinions about the most effective method for diagnosis and treatment. The work of these groups is important, but sometimes their views are later proved to be incorrect.

The human genome has recently developed a promise to get an overview of the disease process, but is a work in progress.

In short, there is not much hard science as you wanted.

So what do we do? I wish there was an answer that offer real value. After all, I am a business executive who runs a health plan providing benefits to thousands of employers. I'm also a taxpayer who supports government programs. Unfortunately, no such guarantees, but there are steps we can take.

Best Course

As a society, we must be honest about the limitations of treatment. Patients should be well informed about what the industry knows and does not know. There should be openness about the likelihood that care for the worse rather than better. Patients should be empowered to be responsible for the treatment.

In recognition of the uncertainties patients face, we must acknowledge their grief with compassion and fear. We need a lawyer that aggressive intervention is not always the best course of action.

I share these conclusions do not indicate dissatisfaction, Linde and I are grateful for your attention. His doctors including the country's most respected physicians, who did what they were trained to do - aggressively seek a cure.

Rather, these observations are offered to challenge the U.S. industry health care to be more explicit about the medical treatment as much an art as a science and to provide emotional and spiritual support to enhance the experience of the patient and the caregiver.

Disease Course

There may be an economic benefit to this. As patients learn more about the limits of medicine, some may choose less intensive and costly care. As a nation, our rising health care costs as patients near the end of life.

Since its inception, Linde cancer has returned twice. The first time, went on a brave and courageous fight. The second time, he learned that additional treatment would be painful, risky and probably leave a partial disability and deformed. He also said the probability of having a longer life and high quality was remote.

With this knowledge, he opted for palliative care facilitate quality of life over prolonging life. My acceptance of his decision, though difficult, was the best way I could show my love and support.

Linde celebrates its doctors for being great teachers. They were sincere, patient, non-clinical terms used, and shared their uncertainty about the effectiveness of the proposed treatment. Your support of it as the decision maker was wonderful.

Linde and I chose to share our trip because we expect the understanding of medicine has developed will be useful to others.