The Negative Impact of Stark Law Exemptions on Graduate Medical Education and Health Care Costs: The Example of Radiation Oncology

Abstract

dose (BED) is high in the target volume, with low dose outside the target volume and small side effect. The overall survival rates of 1-, 2-, 3-year to patients with stage I -II NSCLC were 88%, 78% and 78%. One case of grade III radiation pneumonitis was observed. The overall survival rates of 1-, 2-, 3-, 4-, 5-year to patients with stage I -II liver cancer were 83%, 75%, 58%, 42% and 34% respectively. No liver function damaged was observed during treatment. The grade I -II liver damage was 14%, and 4% with grade III. The overall survival rates of 1-, 2-, 3-, 4-, 5-year to patients with stage I and II pancreatic cancer were 68%, 34%, 30%, 21%, and 17% respectively. The grade I and II gastrointestinal late reaction rate was 9%, and 3% with grade III. Conclusions: The highly focused, hypofractional g-ray SBRT resulted in promising local control and survival rate with minimal toxicity in the treatment of solid organ malignancies, including lung cancer, hepatocarcinoma and pancreatic carcinoma. As a safe and effective radiotherapy technique, it is worthy of being studied and applicated.

The Impact of Financial Interest in Intensity-Modulated Radiation Therapy on the Utilization of Radiation Therapy for Treatment of Newly Diagnosed Prostate Cancer: A Single Center Experience

“…Recently, these centers have become the targets of intense criticism [3, 4]. The detractor's claim that integrated PCa care centers lead to self-referral by financially motivated urologists and radiation oncologists and result in over-utilization of IMRT contributing to the increased cost of health care.…”

“…They further claim that these centers have a negative impact on residency training in radiation oncology by shifting patients away from the academic radiation oncology training programs. Unfortunately, these claims are not substantiated by data, but rather rely on indirect analysis of Medicare claims and a 12% negative impact report from a single 3-point questionnaire survey of 81 radiation oncology training programs [3, 4]. …”

“…Although not yet validated in the literature, this may allow for improved quality of care and decreased cost. Unfortunately, these efforts have been much maligned in both the media and radiation oncology literature as conduits to increased revenue for the urologists with only debatable patient benefit [3, 4]. These reports have not yet been supported by data.…”

Emergence of Integrated Urology-Radiation Oncology Practices in the State of Texas

“…Various arguments have been made for and against the integrated urology-radiation oncology (RO) practice model (5)(6)(7)(8). One argument in favor of the integrated practice model is that physical integration of urology and RO services can allow for more efficient care in certain situations, such as the identification and treatment of severe urologic side effects from radiation therapy (2).…”