Every time I see one of their [expensive] ads on TV, I think about how awful it must be to live in a place where you don’t have access to first rate medical care. Where you might decide that your only hope is to leave home, to travel to a for-profit hospital. Especially one that leads you to believe that they get better outcomes than other health care providers. You know that “other” type: local, non-profit, implicitly not focused on results since they’re not, you know, profit-makers. Losers!
No, Cancer Treatment Centers of America are the Lake Woebegone of health care providers, only instead of all their children being above average, all their cancer treatment outcomes beat the national averages.
Layer on, of course, that their appeal is to people with advanced stage cancer, who desperately want to hear “curable” when their oncologist is telling them “treatable,” or who even more desperately want to hear “treatable” when their oncologist is telling them “end game.”
Trust me when I say that I understand this appeal.
Yet every time I see an ad for the Cancer Treatment Centers of America, I thank my lucky stars that my husband’s cancer is being treated by the magnificent doctors and nurses at the Massachusetts General Hospital. Where we believe that Jim is getting the finest care possible, with an equal – and, more likely, better – probability of a positive outcome than we’d get anywhere else on the face of the earth. Despite what those ads for CTCA, and the glowing stats presented on their web site, are bragging about.
As it turns out, as far as CTCA is concerned, there’s truth in advertising, and then there’s truth in advertising.
And the truthiness of their truth is – as I had long suspected – just a tad bit suspect.
So sayeth a Reuters report on CTCA that came out a couple of weeks ago.
Part of CTCA’s “magic” is turning away most of those who are likely to have not so great outcomes. Like those on Medicare, who don’t have as good a shot at surviving cancer as someone much younger, just because, well, they’re older. And like those on Medicaid, who are poor and, thus, are far more likely to have other health ills – hypertension, diabetes – that make surviving cancer more of a crap shoot.
CTCA is not unique in turning away patients. A lot of doctors, hospitals and other healthcare providers in the United States decline to treat people who can't pay, or have inadequate insurance, among other reasons. What sets CTCA apart is that rejecting certain patients and, even more, culling some of its patients from its survival data lets the company tout in ads and post on its website patient outcomes that look dramatically better than they would if the company treated all comers. (Source: Reuters.)
Reuters engaged with cancer and medical statistics experts who determined that CTCA’s website claims about higher survival rates are “misleading.”
The experts were unanimous that CTCA's patients are different from the patients the company compares them to.
Among other tricks up the old CTCA white-coated sleeve: they count only those patients who weren’t treated elsewhere first. Thus, they don’t include:
…those who have exhausted treatment options closer to home and arrive at a CTCA facility with advanced disease.
So, you’re treated someplace local – someplace great, like MGH, or someplace not so great, like Podunk Community Hospital – and, having survived chemo, radiation, surgery, and whatever else that’s been thrown at you, you’re told that there’s nothing more they can do for you.
Then you see all those healthily glowing folks – folks with your very cancer – who have been cured at CTCA, and you go for it. (Why not?)
So you muster up the strength (and money) for a visit to CTCA, with the promise of better outcomes. (Unless you read the fine print.)
Only to find out that, if they deign to let you in, you won’t be counted as a loss if you die on their watch.
CTCA, of course, refutes that there’s anything misleading about their statistical approach.
But I’m pretty sure that Reuters has got it right.
Which is not to say that some patients don’t get cured there. It’s not as if CTCA is full of quacks giving coffee enemas and swearing that cling peaches solve everything. (They do, however, incorporate some non-traditional treatment methods – think reiki – that are a bit off the beaten path.) And not that their approach doesn’t work for their patients.
The CTCA formula resonates with many patients. According to Healthgrades, a doctor- and hospital-ratings site, CTCA facilities consistently beat national averages in patient satisfaction.
And yet, there are those “statistics” they tout:
CTCA also appears to exclude the vast majority of its patients when it calculates survival data. In survival results from 2004 to 2008 posted on its website, CTCA reported 61 patients with advanced prostate cancer, 97 with advanced breast cancer, 434 with advanced lung cancer, and 165 with advanced colon or rectal cancer. These are the four most common solid tumors. In the same period, CTCA treated thousands of patients at its Zion [Illinois] facility alone, according to filings with state regulators.
A cancer diagnosis is a gut punch. Hearing the words “treatable not curable” is an even bigger one. I can only imagine the gut punch magnitude when you hear the word “hospice.”
So I understand why someone would want to grasp on to whatever sometimes true, sometimes false hope that CTCA is offering.
Me, I’ll take my chances at Mass General.
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