Cathy Meyers had already fought cancer twice, once in 1992, again in 2003, before she was diagnosed for a third time with neuroendocrine cancer in the pancreas in 2009. She thought her time was up. How could fate hand someone a proverbial death sentence three times in a row, with the third being the same cancer that sent Steve Jobs to his deathbed?
In November 2010, she was told by her home oncologist that she had three months until she became too sick to work. She made self-referrals to the Mayo Clinic and City of Hope before she went into work, which just happened to be during open enrollment season. Her employer, Home Depot, had just signed on with Best Doctors, a service that offers a second opinion on medical cases to employees at no cost to the employee. And she thought, "Why not?"
She called Best Doctors and was dispatched to a critical illness clinician. Almost immediately, the service started compiling her health records, not an easy feat for a process that usually takes at least a month.
Meyers had started a second round of chemotherapy when she got a six-page report from Best Doctors, written by a leading oncologist. The report recommended an alternative course of treatment, and after going over the results with her doctor, Meyers started on a steroid regime that includes a monthly shot in the buttocks.
She is still alive today.
"I'm probably the luckiest person I can think of, to be alive and feel good," Meyers says.
Last Christmas, she hadn't even bothered to put up Christmas decorations because she didn't know if she'd be well enough to take them down.
"I didn't know if I had a future; I'd put together a trust, contacted hospice and put together end-of-life affairs," she says. "It's a far cry now to not be in that place."
Saving lives, saving money
The average time a patient spends in the patient room with the doctor is 15 minutes, which several reports have said makes complete care, including diagnosis and treatment, difficult. When it comes to cancer, a study published in The Journal of Clinical Oncology reported that the misdiagnosis rate is around 44% for some types of cancer.
"Each person is unique, and one of the problems in the health care system is that we're all treated as if everyone is the same," says Evan Falchuk, vice-chairman of Best Doctors.
The Best Doctors database contains the top 5% of doctors across 45 specialty areas and 440 sub-specialty areas. The cost usually ranges between $1.50 to $3 for each employee per month, which includes the employee's family.
Right diagnosis, treatment
Falchuk says what he hopes the service does is eliminate unnecessary costs and replace them with necessary expenditures. The program usually delivers a return on investment of 1:1, which increases with clients that support full member engagement.
"The biggest metric is that we get the diagnosis and treatment right, which ought to be how we look at the health care system overall," he says.
He says programs like Best Doctors are needed because hospitals pay for volume, as opposed to for value.
Indeed, nearly one-third of the $2.7 trillion spent each year on health care in the United States are considered to be wasted dollars, according to a report in the Journal of the American Medical Association.
Lesley Leiserson, director of benefits for Home Depot, brought in Best Doctors to "save lives and save the company time and money."
Leiserson says Home Depot hasn't been able to measure the benefit's ROI, mainly because the program is still new and employees who go to Best Doctors are already sick. Still, approximately 29% of Best Doctor patients have an incorrect diagnosis, and 60% have incorrect treatment that is changed by the doctor.
This might lead one to think such a service undermines the expertise of patients' own physicians, but Meyers says she got no pushback from her home doctor on a change in treatment.
"He'd given me not-such-good news, and I had nothing to lose by doing this other thing. He kept me alive until I came to Best Doctors' recommendation," she says.
Falchuk agrees that they rarely get questioning from doctors. "The information that they get is timely, accurate and actionable," he says. "The life of a doctor is under incredible time pressure."
Productivity is maintained
If the recommendations go well, the employee maintains productivity, as Meyers has. "Anything that you can implement that takes waste out the system is a positive," she says. "It's about offering a great resource for an added value," both for the employee and Home Depot.
Meyers shots cost around $6,000 per month, but she only pays a $35 copay. In her previous chemotherapy treatment, she'd taken medical leave and had five doctor visits each week.
"Without it I'd probably be dead, and they wouldn't have to pay anything, but I'm a good sales associate," she says, adding that she likes to think that she sells $6,000 in home appliances every month to make up for that cost and, in return, Home Depot's got a fully productive employee who rarely misses work.
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