He knew it was coming. A medical expert told the 76-year-old, cancer-stricken patient recently that she would get to have the next hysterectomy, despite her desperate request for him to tell the doctor not to. The diagnosis was straightforward: “There was no doubt that it would happen,” said the doctor. “She was clinically very advanced.”
The patient was living alone in a remote part of the state, which means her survival was dependent on her ability to walk. So she needed assistance — good help, but that was still no guarantee that she would get the next procedure she had requested.
Finally, her oncologist stepped in and told her she would have it. Once the person was through with radiotherapy, they’d do the hysterectomy. The woman was not pleased with the offer, but she was not surprised. Doctors, especially those at hospitals like Dana-Farber, are acknowledging that they have to curb unnecessary procedures in a drive to help keep treatment costs down. That means no hospital will be able to make a bed for the patient and say, “Sorry, we don’t have any room.”
For the first time in its history, Dana-Farber ordered the removal of several hysterectomies, or total hysterectomies, from its schedule. They rarely go this far, said Dr. Michael Bonni, a team leader who ordered the measure. It started last September, after a study documented in the New England Journal of Medicine that the cost of one hysterectomy was about 40 percent higher than the cost of a hysterectomy plus surgery to remove the surrounding area — in most cases because of some kind of “medical error.”
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