How Fast Tin Plough Over The Axe A Proton Teach Downwards A Drain?

I've had a number of people write to me upon seeing Jaimy Lee's story inward Modern Healthcare:

The Indiana University Proton Therapy Center volition unopen inward December, marker the commencement fourth dimension a proton-beam therapy centre inward the US of America has unopen its doors since the rapid proliferation of the costly handling centers began virtually a decade ago.

University executives together with an independent review commission attributed the center's financial losses to a attain of issues, including the toll of maintaining its aging cyclotron, merely the commission likewise suggested the manufacture may live on on the verge of a “proton bubble” equally the centers larn by to serve a sufficiently large patient population.  


"Is this a trend?" they inquire me.  The UI had a exceptional commission to assist them inward this matter:

In the committee's report, the reviewers highlight many of the issues affecting the proton manufacture equally a whole, including the lack of completed randomized clinical trials, improvements inward choice treatments, changing attention patterns for patients amongst prostate cancer, together with the rising inward novel payment models, such equally bundled payments that may take away incentives to utilization the therapy.

“It is, therefore, quite possible that nosotros are on the verge of a 'proton bubble' amongst the to a greater extent than indebted centers or those without a rigid patient render business closing,” the commission said inward the report. 

Well perhaps together with perhaps not.  Maybe at that topographic point were local weather condition at work: 

The losses together with challenges were clearly outlined inward the report. The IU centre requires 63 people to staff the cyclotron, spelling high project costs. The technology, which was adapted from a query cyclotron, needed a $30 i M one thousand upgrade. The Bloomington site, which is an hour's drive from Indianapolis, is non ideal for clinical-trial participation because it requires most patients to travel.

The centre reported a $3.5 i M one thousand operating loss inward financial 2013. Another challenge it faced: newer centers are expected to live on opened past times University Hospitals inward Cleveland, Ohio, together with past times the Mayo Clinic inward Rochester, Minn., telephone commutation referral markets.



But i thing is for sure.  The investment inward this machine represents a huge chance toll for the University together with the patients served past times it and, indeed, for other clinical departments.  That taxation on the University volition persist, equally the bonds must all the same live on paid off.  Millions of dollars convey together with volition larn downwards the drain inward back upwards of a engineering scientific discipline amongst express clinical applicability--all purpose of the building complex supported past times selected physicians together with infirmary administrators.  (See the pride amongst which it is described on the website inward a higher house together with inward this 2010 press release announcing a renaming: "We volition live on proud to live on known equally IU Health Proton Therapy Center," stated Dr. Peter Johnstone, president together with CEO, who shared this of import data amongst staff via executive email.)

And all of this is aided together with abetted past times perverse Medicare payments that CMS persists inward maintaining--even equally private insurers declare the handling ineligible for payment.

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