The Cost of Breast Cancer Care: How Much Time is Wasted in the Waiting Room?
A recent study in the Journal of the National Cancer Institute takes a look at the cost of cancer care from a new perspective: the overall cost to the patient of his or her time spent in care. Not the bottom line expenses incurred for treatment–the bills for surgery, chemo, radiation, hospitalization, doctor’s appointments, and so forth–but how many hours the patient spent in treatment multiplied by $15.23, the median U.S. wage rate in 2002. The total, for an aggregate of 11 different cancers tracked during the patients’ first year of treatment alone? A staggering $2.3 billion.
Think about it. How much time have YOU spent on cancer treatment, from diagnosis right on up to today? Especially during that first year, it was probably a substantial amount. And, depending on what part of the country you’re in, just the travel time to and from your medical facility alone could have been mind-boggling. Here in northern New England, where the trees outnumber the people–and in Vermont, where even the cows outnumber the people–cancer centers are widely spaced, to say the least.
I know of several women who drove just about 6 hours round-trip, every day, for radiation. And we’re not talking an easy drive along the straight, temperate-weather roads of the South. We’re talking travel slowed by rain, sleet, snow, ice, even moose and coyotes–so it’s not just time spent driving, it’s stressful time spent behind the wheel. There’s a dollar cost to that–hours spent times your hourly wage. But the emotional cost may be even higher.
And once you get where you’re going, there’s the time you spend waiting for treatment. Efficient as your medical center may be, you know the inevitable routine: read a magazine, stare into space, have some blood work done, check out the newspaper, see your doctor, go down to X-ray for some quick film, change into a hospital johnny, leaf through the latest dog-eared copy of “People,” then wait. Wait. Wait... If, as they say, time is money, then there’s an awful lot of money being spent as you wind your way through a half-day or day of treatment.
What does this mean to us, as patients? And to the society we live in? If you’re employed, you may be lucky enough to work at a flexible, salaried job, a job where you can set your own schedule, so long as you finish your work. What that means, when you’re undergoing cancer treatment, is you simply work more hours. For every hour you’re in treatment, keep the boss happy by tacking an hour onto your work week. Cost to your employer: Zero. Cost to you: Extra fatigue and stress, at a time you could do without it.
If you’re in a non-flexible or hourly-wage job, you’ll be taking time off: sick time. There’s little hope the amount of paid sick leave you’ve accrued will come close to matching the amount of time you need to take off. Whoops–there goes the paycheck. Cost to your employer: nothing, in dollars; though your work product will be reduced by the amount of hours you’re not on the job. Cost to you: both dollars, and stress.
Multiply these two scenarios by the millions of working cancer patients undergoing multiple days and sometimes weeks and months of treatment each year, and it’s clear there’s a great cost to society. To me, to you, to our employers who rely on our work, and to our families who rely on our paychecks.
Scott D. Ramsey, M.D., of the Fred Hutchinson Cancer Research Center in Seattle wrote, in an editorial accompanying the study article, “We hope that policy makers recognize the substantial economic burden of cancer in the United States and that this cost derives from many sources.” Not just the cost of drugs and surgeries alone, but the cost to the patient and his or her employer in lost work time.
The editorial concludes that “new treatments that reduce patient time costs should be encouraged, and manufacturers should quantify these benefits and convey them to patients, providers, and health insurers.” Amen to that. BUT–with the focus on curing the patient, as it should be–where can the time and dollars come from to streamline the processes that deliver that cure?
Published On: January 03, 2007