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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.

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