Home > Uncategorized > “Pathways Reconsidered: Let’s Not Stop Thinking Outside the Box”

“Pathways Reconsidered: Let’s Not Stop Thinking Outside the Box”

Dr. Stephen Fox of Paoli, PA is well worth quoting without further comment, regarding the increasing pressure on oncologist from insurances and bureaucracies to treat patients with proscribed “pathways” in the name of cost effectiveness :  “… pathway recommendations may work for the majority of patients, but perhaps 20% of patients will be best served by using therapy that is divergent from these accepted pathways… I have been in practice for close to 30 years and have learned the importance of “thinking outside the box.”  I have had major successes with drugs that were not considered to be the standard of care… I understand that reimbursement is a major issue in the current economic environment. I also concede that pathway development is ongoing, evolving, and will generally be a good thing. Nevertheless, I would like to see those of us who attempt to advocate for patients and think outside the box be given some recourse to treat our patients discordant with pathways on occasion, and when and if the physician feels strongly about the need to treat a patient differently… After all, if all we needed were pathways to decide on clinical treatments, we might as well just slip them into a computer with the patient’s records and go dishing” (from ASCO Post Sep 15 2011, p.41). Bravo, Dr. Fox !

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