Pat Killingsworth Pat Killingsworth

Profit Before Patients: The Conclusion To An Alarming Story About How & Why Doctors, Clinics & Hospitals Purchase Bone Marrow Biospy Systems

As I stated Wednesday, I originally approached this story with cost savings in mind. But I was focused on the industry saving thousands of dollars a patient by using the mechanized OnControl drill instead of sedated biopsies.

But yesterday I shared with you how few patients undergo sedated biopsies.  So while I think they should become an option for more patients, that isn't the ultimate point of my story.

Let's review.  Both the TrapSystem and Ranfac's basic Snarecoil tray are  priced at less than $30. Cardinal, the international sales leader in the field, offers their trays for $16. 

Best I can tell, all three of these manual systems feature advantages and disadvantages--but are conceptually the same.  So a medical center using Cardinal supplies is going to save an average of around $14 a patient. 
The new OnControl automated drill system needs a few extra pieces and parts, driving their per tray cost up to between $85 and $100.

All four companies provide complimentary tools to institutions who purchased their product.

OK.  Can we all agree--in the incredibly expensive world of modern medicine--a difference of around $60 shouldn't matter if patients are better served and more comfortable?

I'm pausing here once again.  I want to note I am not pushing OnControl's product.  I do not work for Vidacare.  This drama isn't about them.  This story is much bigger than that.

So here goes.  Let's raise the curtain on our final act.  Why aren't patients needs and feelings being placed before profits?  What did I learn in Orlando which upset me enough to write a lengthy, four day expose'?

During the course of my research and interviews, I learned the reason the biopsy medical equipment market is driven more by cost than features or patient comfort is simple:  Profit!

Apparently Medicare and a majority of insurance companies reimburse clinics and/or doctors a set rate per procedure.  Several people I talked with "off the record" believed this rate to be around $160.  This is far less than an average of $300-$400 which is billed nationally for a non-sedated biopsy.

Using the $160 figure as part of  a hypothetical example, here is how the system works.  A group of three doctors own and operate a small, local oncology clinic.  If they use Cardinal's system, they pay-out $16 and pocket the difference--in this example $134.  Use one of the other, slightly more expensive manual systems and they net $130.  But if they go to the automated OnControl system, they only keep around $70. 

So no matter how uncomfortable it is for the patient, profit once again triumphs over patient welfare.  Let me ask my readers:  How does it make you feel, knowing your clinic or doctor is "selling you out" for a mere $70?

Wanting to avoid doing a more expensive procedure because it is unnecessary and the right thing to do--that I understand.  But to make an important decision like this based solely on profit?  Despicable!

Think back to the story I shared with you about Helen, the 84 year old patient from Rockford, Illinois. Why didn't her doctor allow Helen to get a sedated biopsy?  Why did he intimidate her--and that is exactly what snapping at a patient and saying "None of our patients ever get a sedated biopsy." is--bullying and intimidation.

Why?  Because Helen would need to leave his facility.  The hospital would get her business, not him or his practice.   This is shameless--and so disappointing!  I understand running a medical practice is challenging.  But shouldn't the patient's well being come first?  Maybe an option as simple as using the OnControl system--without sedation--might be a compromise her physician should consider.

If we were just talking about a few, greedy and insensitive doctors, this wouldn't be much of a story.  But according to people I have since talked with in the industry, this is "how the system works."

To quote one of my unnamed sources who works for a company which sells manual bone marrow biopsy systems, "Why do you think Cardinal sells so many biopsy trays?  Because the doctor or clinic pockets the savings!"

My wife, Pattie, has worked as an administrative assistant for a large Florida dialysis clinic for almost two years.  She often shares some pretty scary stories with me about how patients are treated by Medicare and Medicaid.  But even she was disturbed by how this system works. 

I spoke with a leukemia patient last evening.  She told me her oral chemotherapy costs $1000 per pill.  My 10 mg Revlimid capsules cost $510 each.  According to CompareMRICost.com, the average MRI in Raliegh, NC is over $3000.  HealthcareFees.com lists the average cost of a simple appendectomy at
$18,768.

So you are telling me we can't spend an extra $70 to spare an elderly patient--or someone like me with hard bones--a lot of unnecessary pain and discomfort?

I took some time to watch the reactions of physicians and hospital administrators as they stopped at each of the bone marrow biopsy system exhibits.  Not only did many of them feel the OnControl system was too expensive, a number of them felt the same way about spending $25 or $30 for the HS or Ranfac systems.

My reaction as a patient who has experienced a difficult, painful biopsy:  Go right ahead and use Cardinal's less expensive, manual system... As long as you give me the drugs, baby!

Feel good and keep smiling!  Pat
  • Jaya Tiwari

    Really interesting information. Thanks for sharing!