Recently the [state of] New York signed a law requiring hospitals and doctors to discuss breast reconstruction options with the patient prior to her undergoing cancer surgery. It troubled me that this law was needed. Is it not the duty of the physicians and surgeons to educate the patient on the options available?
We need to make sure the patient and their family know of the treatment options which may vary depending on the diagnosis and stage: Radiation, chemotherapy, surgery (lumpectomy, mastectomy, axillary dissection) — a combination of treatments.
Even if the patient and her physicians don’t chose to do immediate reconstruction, isn’t the discussion and information part of the discussion? At least inform the patient of the option.
Do we physicians and surgeons need another law to ensure we do right by our patients?
Not all patient’s have health insurance so reconstruction may become unattainable due to finances. Susan G. Komen has a nice resource page for financial assistance available for breast cancer patients. I did not see any that would cover reconstruction. Many will help will obtaining a prosthetic.
Patients who do have health insurance are afforded protection under the “Women’s Health and Cancer Rights Act of 1998″ (WHCRA). However, as I was reviewing and researching the WHCRA for this piece, I learned that it’s not a blanket protection:
Generally, group health plans, as well as their insurance companies and HMOs, that provide coverage for medical and surgical benefits with respect to a mastectomy must comply with WHCRA.
However, if your coverage is provided by a “church plan” or “governmental plan”, check with your plan administrator. Certain plans that are church plans or governmental plans may not be subject to this law.
Breast Reconstruction—Part I (October 2007)
Breast Reconstruction – Part II (October 2007)
Before Breast Is Removed, a Discussion on Options; New York Times article, August 18, 2010; Anemona Hartocollis
“Women’s Health and Cancer Rights Act of 1998’’ Summary; American Society of Plastic and Reconstructive Surgeons website
Your Rights After A Mastectomy…Women’s Health & Cancer Rights Act of 1998; Department of Labor
*This blog post was originally published at Suture for a Living*