Wednesday, May 27, 2015

Scripting Scripps

Gary Schwitzer and his buddies at Health News Review are the experts in critiquing medical stories, noting:

The mission of is to improve the public dialogue about health care by helping consumers critically analyze claims about health care interventions and by promoting the principles of shared decision-making reinforced by accurate, balanced and complete information about the tradeoffs involved in health care decisions. evaluates health care journalism, advertising, marketing, public relations and other messages that may influence consumers and provides criteria that consumers can use to evaluate these messages themselves. Improving the quality and flow of health care news and information to consumers can be a significant step towards meaningful health care reform.

In this respect, they are performing an excellent public service.  As a sole writer in my home office, I can't keep up with their expertise and output, but every now and then, a story comes along that deserves some commentary.

I really don't want to keep writing about proton beam therapy, but here's the latest from HealthLeaders Media.  Read it and weep:

The facility that houses the pencil-beam PBT devices at Scripps is owned by Advanced Particle Therapy, which spent about $220 million to develop the site. Even with that jaw-dropping price tag, Scripps has managed to achieve cost-competitiveness with photon-based treatments for some tumors, including early-stage breast cancer, Rossi told me.

"We can treat patients in two weeks compared to as many as seven weeks with other forms of radiation therapy. … We're able to treat them in a faster manner, with the same toxicology and the same side effects. It also cuts the costs of treatment dramatically."

Although Rossi declined to name names, he says two commercial payers have concluded that pencil-beam PBT at Scripps is delivering more cost-effective treatment for early-stage breast cancer than comparable photon-based radiation treatment. "Insurers have looked at this and said we are cheaper and contracted on that basis."

In the PR business, we call this "earned media." It's essentially an advertisement that hasn't been paid for.  There is no critical analysis of the points made by the protagonist.  There's no alternative view presented on the contentions offered.  Let's deconstruct:

The facility in question represents $220 million in capital costs that has to be amortized over some period of time.  In addition, there are operating expenses.  The method of how those costs are amortized over each early-stage breast cancer case is not stated.  Specifically how much is the fully loaded cost of two weeks of proton beam therapy compared to the fully loaded cost of seven weeks of photon therapy at Scripps or other institutions? Since we are not presented with those basic assumptions, there is no way to independently evaluate the basic contention, that Scripps has managed to achieve cost-competitiveness with photon-based treatments.

We also are told that two commercial payers have concluded that the therapy is more cost-effective, but Rossi declined to name names. Why on earth would you print such an assertion--made by a clinician--on behalf of insurance companies without verifying it with the primary sources. (I can understand when reporters allow sources to remain anonymous for reasons of national security or personal risk or commercial privacy, but here, the sources haven't even been interviewed.)

There are many other thoughtful and interesting parts of the story, but those are "after the turn." Most people will not get to page two or three of the article, and thus the main impression is that Scripps has done something that no one else in the industry has found to be possible.

I'm thinking that Schwitzer et al should start to conduct training programs for their colleagues in journalism.


Cheney said...

Full disclosure: Both you and Gary Schwitzer were given the opportunity to comment for this health plan column on PBT. You both punted, and the one source Mr. Schwitzer suggested did not respond to a request for comment.

Paul Levy said...

My comment to your reporter:

"Thanks, Chris, but I don't think I'd be able to comment on that right now, and surely not without objective reports on the topic from people who've studied the matter."

Gary can respond on his own.

I'm sure my readers will appreciate how you are trying to switch the blame for your own incomplete reporting.

MG said...

Hi, Paul: one point of clarification. Varian Medical Systems does not own the site. Varian provided the proton therapy technology being used at the site, but the site was developed by a company called Advanced Particle Therapy (APT), which is based in San Diego, not Palo Alto.

Best regards,

Meryl Ginsberg
Director of Public Relations
Varian Medical Systems

Paul Levy said...

Thanks, Meryl. Best tell the reporter. I just excerpted from his story.

MG said...

Yes, his story has been changed and it would be great if you could make the commensurate change. Thanks!

Paul Levy said...

Done, thanks.