this gives me such hope. im literally afraid to go to a doctor because of all the lies etc. i know there are good doctors. just have to find them. God bless you. i have a smile on my face and in my heart because of you. thank you
So true! But everyday I feel like I am fighting the system to do the right thing by my patients. That alone can be exhausting. And I am sad because I know my daughter in medical training wants to do the right thing but is being taught fealty to the “system” everyday.
What can be done to break the medical industrial complex such that doctors and nurses don't have to skirt or even break "the rules" to deliver the care they're compelled to provide their patients? Will doctors like Prasad opt out of the hospital system and provide care in a private practice, with others of a like-minded persuasion?
Won’t help. The industry controls the purse strings. The purse strings control the governing bodies. The governing bodies control the algorithms. They kick out the thinking thoughtful physicians and second levels are taught to follow algorithms. The rich get richer. People get lots of unnecessary work up and treatment. The poor die.
Talented people undertake years of medical studies and training because they want to help. Must be a harsh awakening for them when they find themselves part of a U.S. healthcare System that charges fees-for-service regardless of whether they help the patient or not, benefitting the hospital systems above everyone else.
The United States spends more per capital on healthcare than any other advanced economy, and is the vanguard of scientific innovation, yet Americans see less benefit, have much lower heath status, and life expectancy is actually declining for the first time in history--See Robert Johnson's recent book, "The Customer Revolution in Healthcare". Dr. Prasad is unusual because he's willing to drive through the broken system to make sure he gets things done for patients.
The Nixon Administration launched the War on Cancer over fifty years ago. So why is the system still waiting until chronic symptoms like tumors can be seen on scans and felt by doctors? Why is the "standard of care" for most cancers still surgery followed by toxic chemotherapies and radiation that so often cause the patient all kinds of "treatment effects" before too-often failing (the highest risk cohort for cancer is previous cancer patients)? Maybe because there's less profit at the moment in prevention.
President Biden's recently re-launched the "Cancer Moonshot" is easily assumed to be looking for scientific innovation. Yet, we might already have nearly all the science we need. In recent decades since the de-coding of the human genome, scientists have come to understand human biology and the mechanisms by which genetic mutation leads to a cascade of other molecular problems affecting proteins, metabolism and and other biological systems, essentially evading or overwhelming our immune systems.
Other advanced nations (ex. England, Canada, Israel) with single-payor systems are starting to use a systems biology approach, monitoring peoples' biological condition longitudinally; examining how molecular, lifestyle and environmental factors create problems; and investigating methods of intercepting these problems before they cascade into end-stage symptoms (tumors in cancer, mis-folded proteins in neuro-degenerative conditions). These single payor national health systems can and are easily deciding to pay for the testing that will enable early disease interception. Where are U.S. Medicare and Medicaid on this? Private health insurers?
Healthcare should be about staying healthy for longer. If we need a "Moonshot", it's in seeing and addressing the problem differently, as one of Institutional Innovation. Dr. Prasad and his colleagues will surely be gratified when they're able to stop cancer before it becomes life-threatening. Fewer scans, radiation and drugs might be less lucrative for the hospitals, but no doubt they'll be plenty of profit in observing and managing outcomes longitudinal biology too.
Thank you for being a decent, caring human being. I know that doctors follow a rough road these days, and I’m encouraged to hear that you are pushing through the flawed system and doing the right things. Blessings and Grace to you.
“She must have thanked us 100 times for our help. Despite all she had endured, she was a joyous person.” This is inspirational - even transcendent. Recovery and thriving are never guaranteed. Sounds like she willed it into being.
I just finished your book "Malignant" and, as a former cancer patient, found it enlightening and informative. But it didn't move me as much as this short essay did. I wanted to cry. Not just bc of the "end of the story" or that you and your nurse truly CARED about this woman , but because I believe this story is an outlier. (by far) While I was cured of my easy to cure cancer and for that, I am grateful , I felt the whole way through that I was just cattle. From the doctors who talked about a mastectomy like it was no big deal (I declined) to the hospital that employed a barely out of teens intern who understood nothing to check me in for surgery, instructing me to undress, use a wipe on my torso (that caused an awful rash) and put on a ridiculous gown for my 5'1" 105 pound body, and a lot of other complaints, very few in this industry care about the patient. Humans are a selfish lot and doctors are no exception. Dr. Prasad, you are the rare exception. It doesn't have to be this way but the incentives make it so.
Proper diagnosis and treatment are paramount. With today's advancement in treatments, I hope to live long enough until all cancer is curable. As a young practitioner, I did numerous surgeries for female genital cancers, and if they were diagnosed in a timely fashion, almost 100% curable. Sub-specialists took away that task thankfully. Every year we get closer and closer to the goal.
Again-early diagnosis is vital. My wife of 50 years had breast Ca that was node negative. Early diagnosis has spared me the agony of watching her waste away.
Beautiful. Thank you for sharing.
this gives me such hope. im literally afraid to go to a doctor because of all the lies etc. i know there are good doctors. just have to find them. God bless you. i have a smile on my face and in my heart because of you. thank you
There are doctors like that; but there are a lot of businessmen with medical degrees.
So true! But everyday I feel like I am fighting the system to do the right thing by my patients. That alone can be exhausting. And I am sad because I know my daughter in medical training wants to do the right thing but is being taught fealty to the “system” everyday.
What can be done to break the medical industrial complex such that doctors and nurses don't have to skirt or even break "the rules" to deliver the care they're compelled to provide their patients? Will doctors like Prasad opt out of the hospital system and provide care in a private practice, with others of a like-minded persuasion?
Won’t help. The industry controls the purse strings. The purse strings control the governing bodies. The governing bodies control the algorithms. They kick out the thinking thoughtful physicians and second levels are taught to follow algorithms. The rich get richer. People get lots of unnecessary work up and treatment. The poor die.
Talented people undertake years of medical studies and training because they want to help. Must be a harsh awakening for them when they find themselves part of a U.S. healthcare System that charges fees-for-service regardless of whether they help the patient or not, benefitting the hospital systems above everyone else.
The United States spends more per capital on healthcare than any other advanced economy, and is the vanguard of scientific innovation, yet Americans see less benefit, have much lower heath status, and life expectancy is actually declining for the first time in history--See Robert Johnson's recent book, "The Customer Revolution in Healthcare". Dr. Prasad is unusual because he's willing to drive through the broken system to make sure he gets things done for patients.
The Nixon Administration launched the War on Cancer over fifty years ago. So why is the system still waiting until chronic symptoms like tumors can be seen on scans and felt by doctors? Why is the "standard of care" for most cancers still surgery followed by toxic chemotherapies and radiation that so often cause the patient all kinds of "treatment effects" before too-often failing (the highest risk cohort for cancer is previous cancer patients)? Maybe because there's less profit at the moment in prevention.
President Biden's recently re-launched the "Cancer Moonshot" is easily assumed to be looking for scientific innovation. Yet, we might already have nearly all the science we need. In recent decades since the de-coding of the human genome, scientists have come to understand human biology and the mechanisms by which genetic mutation leads to a cascade of other molecular problems affecting proteins, metabolism and and other biological systems, essentially evading or overwhelming our immune systems.
Other advanced nations (ex. England, Canada, Israel) with single-payor systems are starting to use a systems biology approach, monitoring peoples' biological condition longitudinally; examining how molecular, lifestyle and environmental factors create problems; and investigating methods of intercepting these problems before they cascade into end-stage symptoms (tumors in cancer, mis-folded proteins in neuro-degenerative conditions). These single payor national health systems can and are easily deciding to pay for the testing that will enable early disease interception. Where are U.S. Medicare and Medicaid on this? Private health insurers?
Healthcare should be about staying healthy for longer. If we need a "Moonshot", it's in seeing and addressing the problem differently, as one of Institutional Innovation. Dr. Prasad and his colleagues will surely be gratified when they're able to stop cancer before it becomes life-threatening. Fewer scans, radiation and drugs might be less lucrative for the hospitals, but no doubt they'll be plenty of profit in observing and managing outcomes longitudinal biology too.
https://www.project-syndicate.org/commentary/new-cancer-moonshot-genetic-knowledge-by-daniel-j-arbess-2022-02?utm_term=&utm_campaign=&utm_source=adwords&utm_medium=ppc&hsa_acc=1220154768&hsa_cam=12374283753&hsa_grp=117511853986&hsa_ad=499567080222&hsa_src=g&hsa_tgt=aud-1249316000797%3Adsa-19959388920&hsa_kw=&hsa_mt=&hsa_net=adwords&hsa_ver=3
Beautiful story.
Good news written with love
That's a good point.
Wonderful article to read on Thanksgiving! Thank you, Dr Prasad!
Dr Prasad, Thank you.
Thank you for being a decent, caring human being. I know that doctors follow a rough road these days, and I’m encouraged to hear that you are pushing through the flawed system and doing the right things. Blessings and Grace to you.
“She must have thanked us 100 times for our help. Despite all she had endured, she was a joyous person.” This is inspirational - even transcendent. Recovery and thriving are never guaranteed. Sounds like she willed it into being.
Thank you for your story.
I just finished your book "Malignant" and, as a former cancer patient, found it enlightening and informative. But it didn't move me as much as this short essay did. I wanted to cry. Not just bc of the "end of the story" or that you and your nurse truly CARED about this woman , but because I believe this story is an outlier. (by far) While I was cured of my easy to cure cancer and for that, I am grateful , I felt the whole way through that I was just cattle. From the doctors who talked about a mastectomy like it was no big deal (I declined) to the hospital that employed a barely out of teens intern who understood nothing to check me in for surgery, instructing me to undress, use a wipe on my torso (that caused an awful rash) and put on a ridiculous gown for my 5'1" 105 pound body, and a lot of other complaints, very few in this industry care about the patient. Humans are a selfish lot and doctors are no exception. Dr. Prasad, you are the rare exception. It doesn't have to be this way but the incentives make it so.
Praying for your daughter, you, and your family. Please stay in touch and let me know how I can help or even if you just need someone to listen.
Proper diagnosis and treatment are paramount. With today's advancement in treatments, I hope to live long enough until all cancer is curable. As a young practitioner, I did numerous surgeries for female genital cancers, and if they were diagnosed in a timely fashion, almost 100% curable. Sub-specialists took away that task thankfully. Every year we get closer and closer to the goal.
Again-early diagnosis is vital. My wife of 50 years had breast Ca that was node negative. Early diagnosis has spared me the agony of watching her waste away.