Despite claims suggesting otherwise, inappropriate cancer patient demands are few and very rarely lead to unnecessary tests and treatments from their health care providers, according to new results from a study that will be presented by researchers in the Abramson Cancer Center  (ACC) and the Perelman School of Medicine at the University of Pennsylvania during the annual meeting of the American Society of Clinical Oncology (ASCO) in Chicago in early June (Abstract #6530).

The Penn Medicine team, including lead author Keerthi Gogineni, MD, MSHP, an instructor in the division of Hematology-Oncology in the ACC, surveyed 26  oncologists and nurse practitioners immediately after patient encounters at the ACC—2,050 in total—to determine frequency of patient requests or demands for tests and treatment, whether those requests were appropriate, whether they were granted and why.

“The results from this new study help debunk many of the misconceptions people have about patient demands leading to unnecessary tests and treatments as a major source of higher health care costs in the US,” said Gogineni.  “In this study, inappropriate cancer patient demands were uncommon, and in less than 1 percent of the cases did providers order an inappropriate treatment or test when requested by patients.  

“Clinicians felt that the majority of patient directed requests were appropriate. The data suggests that rather than being driven by patients to employ low-value, high cost care, most of the time oncologists and nurse practitioners incorporated patients’ requests into a suitable plan of action.”

Questions about patient demands were raised last year after results from a study presented at ASCO by Penn Medicine researchers revealed that over 80 percent of the general public, 69 percent of patients, and 70 percent of doctors surveyed believed hospitals and doctors conducted unnecessary tests and provided unnecessary treatments, and over 50 percent believed patients requested unnecessary tests or treatments.

Was this happening and could cancer patient demands be part of the problem?  The questions are important ones to explore, particularly in the oncology setting, where drugs and tests can get expensive.

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