ASH Clinical News November 2015 | Page 66

BACK of the BOOK Heard in the Blogosphere New Prescription Drugs Help, But Their High Prices Harm In the Los Angeles Times, doctors and analysts discuss the costs of “groundbreaking” drugs – to the patients and the pharmaceutical companies – and potential solutions. The Problem With Satisfied Patients When the Department of Health and Human Services decided to base 30 percent of hospitals’ Medicare reimbursement on patient satisfaction survey scores, many hospitals adopted the concept of “patient experience,” characterizing patients as customers. However, this misguided attempt to improve health care has led some hospitals to focus on making people happy, rather than making them well, according to experts interviewed in The Atlantic. “Now we are told as nurses that our patients are customers, and that we need to provide excellent service so they will maintain loyalty to ou r hospitals. The patient is NOT always right. They just don’t have the knowledge and training.” —Amy Bozeman, RN, registered nurse at MD Anderson Cancer Center “Everybody would agree we want a lot of investment flowing into the search for better drugs. We all have to agree it’s not a blank check.” —Steven D. Pearson, MD, MSc, founder and president of the nonprofit Institute for Clinical and Economic Review “The problem is everyone wants to get the good drug at the same price as the old drug. Why should they be punished when the drug is significantly better? Shouldn’t they be rewarded?” “Too often, the entire discussion is about the cost of these medicines and largely ignores the tremendous value they provide to patients. New medicines are coming to the marketplace that are completely transforming how cancer is treated in this country. Hepatitis C is now cured in 90% of patients. That is nothing short of groundbreaking.” —Robert Zirkelbach, senior vice president of Pharmaceutical Research and Manufacturers of America —Michael Yee, a biotech analyst “Focusing on what patients want – a certain test, a specific drug – may mean they get less of what they actually need. In other words, evaluating hospital care in terms of its ability to offer positive experiences could easily put pressure on the system to do things it can’t, at the expense of what it should.” —Theresa Brown, PhD, BSN, RN, clinical nurse at the University of Pittsburgh “Patients can be very satisfied and dead an hour later. Sometimes hearing bad news is not going to result in a satisfied patient, yet the patient could be a well-informed, prepared patient.” —anonymous Missouri clinical instructor Publish or Perish Culture Encourages Scientists to Cut Corners “In the end, science is a human endeavor. And like humans everywhere, those who work in it will do what they are rewarded for, for better or for worse. So, we need to make sure those reward structures are encouraging good quality research, not the opposite.” —Virginia Barbour, DPhil, chair of the Committee on Publication Ethics, in The Conversation Follow ASH and ASH Clinical News on: @ASH_Hematology and @ASHClinicalNews Facebook.com/AmericanSocietyofHematology @ASH_Hematology 64 ASH Clinical News Breaking Good News Can Be as Hard as Breaking Bad “The truth is that what physicians like to think of as good news may not be shared by the patient. While a physician might think it is good news that the patient is ready to be discharged to a nursing home, the patient may have bad associations with nursing homes. … Teaching physicians how to break good news is as critical as teaching them how to deliver news that is not. … Emphasize the patient’s own role in overcoming adversity.” —Haider Javed Warraich, MD, from Duke University Medical Center, in The New York Times November 2015