The annual ASCO gathering is now in its last 48 hours, and it has been interesting. I have heard discussions concerning payment reform, oncology medical homes, and value based care. The highlighted plenary presentations concerning what appears to be a major clinical advance in the treatment of melanoma is cautioned not only by its potential physiologic toxicity but also by its financial toxicity. Cost effectiveness and treatment value are highlighted as the subject of many abstracts as well as many educational sessions.
ASCO has devoted quite a bit of this year's educational platform to practice issues. ASCO has made the overt decision to integrate such important issues into the science of Oncology and it should be applauded for taking this tact and encouraged to continue. The reality is that this marriage between science and value-based assessments of that science has been, is now, and will forever be a part of what occurs in the clinic.
In a week the American Medical Association (AMA) House of Delegates (HOD) convenes in Chicago. I know that ASCO representatives to that meeting will hear the same issues repeated by those representing the many branches of the “house of medicine.” The issues will be framed in "Reports" and "Resolutions" rather than abstracts but the almost fever-pitched concerns will be the same.
I realize more and more how linked our profession is with the rest of medicine. Our science may be unique but our ability to put that science to meaningful clinical use is defined on a much larger stage that will demand collaborative solutions. Subsequently, any solutions we may pursue will have to be in conjunction with medicine and society as a whole. That comment sounds pretty ethereal, but it could not be more real. So much more to do and much more to come . . .
Ed Balaban, DO, FACP, FASCO
ASCO Delegate to the AMA HOD