When I interviewed Manali Patel, MD, a Stanford oncologist, for an article on improving poor-prognosis cancer care, she cited a shocking statistic: Less than a third of oncologists have end-of-life discussions with terminal cancer patients. She went on to tell me:
Many patients are rushed off to chemotherapy without understanding the big picture. And when predictable treatment side effects happen at night and on weekends, patients who are unable to reach their oncologist end up in misery in emergency rooms and hospitals. Later in their illness, many die painfully in intensive-care facilities that bankrupt their families emotionally - and sometimes financially.
With gritty determination, Patel is working to change all this. A little over a year ago, she joined a small, idealistic band of physicians, engineers and management scientists at a new Stanford center tasked with battling the waste and perverse financial incentives in America's increasingly unaffordable medical system.
I followed Patel for six months, as she refined her plan for better cancer care and went on the road to sell it to a medical system resistant to change -- in the middle of coping with a mother with cancer.
To read her inspirational story, check out the latest issue of Stanford Medicine magazine, which also includes a special report on the money crunch in medicine.
Previously: The money crunch: Stanford Medicine magazine's new special report and New Stanford center to address inefficient health care delivery
Photograph by Jamie Kripke