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Why did the patient in the first story absolutely need to travel from Ohio to Texas for treatment? Isn't medical knowledge shared between providers?

Some of the blame in many of these situations should fall upon the patients for choosing the care they did. Especially when it is a planned operation. I haven't finished reading the whole article, but so far it doesn't seem to be considering this point. I don't wish to defend the existing system in any way, but these providers just seem to be giving people what they ask for.

I used to work at M.D. Anderson and I can attest to their quality of care. People travel from around the world to receive treatment, for good reason.

Also, my mother was a patient there. She started treatment just a couple of months after I got my job actually. She's still doing well years later, and is glad she waited an extra month to get into M.D Anderson. The decision to wait was excruciating though.

But...Ohio has Cleveland Clinic, Case Western University Hospital, Ohio State Medical Center...it is not like it is a total medical backwater. Cynically, Cleveland Clinic has an InterContinental hotel inside the hospital for visiting dignitaries/medical tourists...

Definitely not - but in cases where healthcare is involved, especially cancer, people are motivated to travel to what is considered the best. In cancer's case, it's the big three: MD Anderson, Sloan-Kettering, or the Mayo Clinic.

One more data point: Our pediatrician has always been great and keeps up with new treatments and such. When her husband was diagnosed with cancer, she said immediately they were leaving Iowa to get better cancer care. That said a lot.

The reasoning seems pretty cut and dry as well in consideration with cancer - the patient wants to live, and is likely going to be spending tens of thousands of dollars on care already - what's another few thousand to relocate and live where the best care is available?

You seem to have some firsthand knowledge of the situation, maybe you can help me with the question I posed earlier.

This medical center in Texas seems to be providing a great level of service. I am wondering why patients need to attend directly to get this level of care. I thought that medical findings were published in journals and shared among professionals in the field.

If M.D. Anderson has a dozen (or a hundred) doctors that are experienced in the treatment of certain diseases, why aren't they sending half of those doctors out to other parts of the world to spread that knowledge?

Your questions are very good, and I answer them below briefly in the interest of expediency, not to be rude.

1. Some knowledge is shared in journals; most knowledge isn't published until years after it's established. Much is never published, and is learned through word of math, and institutionally encoded. MD Anderson is world-renowned for being a center for excellence in cancer care.

2. Doctors don't read every article published in every journal related to their work. Even if they did, or read much of it, synthesizing into practice is a very different (and difficult) matter. Many of them don't read at all.

3. Why would MDs want to be send worldwide? And why would MD Anderson want to send them all over? Who pays for this? How can a doctor affect change in a large hospital system?

I think the systems of institutions and people that treat cancer reflect the complexity of the problem itself. The research atmosphere and constant professional development are just as important as individual bedside interactions.

That said, all of the hospitals mentioned here are doing amazing things every day, and finding the best place for treatment really does come down to the specifics of each case.

Someone I know was diagnosed with cancer. In Oklahoma they were prescribed a treatment plan. They went for a second opinion at MD Anderson. Anderson said that plan was dangerous and very well might lead to a bad outcome. The Oklahoma team said MD Anderson's plan would lead to a bad outcome. MD Anderson gets tougher cases and has the best overall outcomes of any hospital in the world so they went with them.

They're fine now and the standard of care at MD Anderson is mind blowing. At MD, a nurse comes in to draw blood and the whole routine is an organized set of steps. If one step changes, they throw away the kit, wash their hands and start over. In Oklahoma nurses just kind of did things however they wanted and gloves seemed more to protect them from the patients than to protect the patients from an accidental infection. There was just zero comparison in the overall standard at MD Anderson. Add in their outcome averages and the question becomes why wouldn't someone travel from Ohio to Texas.

The medical system should choose the most viable care for them. They are not meant to be experts in this stuff, right?

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