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SHAHABI: Why not all health care starts in Washington
Community hospitals make breakthroughs without federal funding
Question of the Day
The constant drumbeat of frightening budgetary news from Washington, whether it be sequestration, a government shutdown or a general inability to even propose an annual budget, has been both a lesson in social studies and science.
Although the shutdown is now over and federal functions have resumed, many Americans have learned for the first time that the government spends more than $30 billion on medical research on diseases such as cancer, diabetes, autism and other real ailments that often hit very close to home. Many of the sickest patients are treated as part of cutting-edge clinical trials at the National Institutes of Health Clinical Center, which the shutdown had prevented from accepting new patients.
The recent closure came as a surprise to organizations that support the National Institutes of Health, and they bemoaned its lack of sustained funding and inability to continue its important work. These advocacy groups, which have grown louder over the past year, present the problem as a stark choice: either increase funding for their work or risk a medical apocalypse.
Perhaps the nature of political advocacy is to talk in extremes, but with increased funding unlikely and a research funding catastrophe too abstract for citizens to understand, we need to discover a third way.
The fact is that the vast majority of patients are treated outside of the cutting-edge National Institutes of Health and the mega-hospitals and research centers that receive most of the funding and make headlines with their breakthroughs.
Rather, the majority of patients are treated in community medical centers, like Danbury Hospital, where I am chairman of the tumor-biology research laboratory and the obstetrics and gynecology department. Outside the headlines, we are finding our own breakthroughs with private funds.
Most of my practice at the hospital involves treating patients with gynecologic cancer, often difficult to diagnose and even more challenging to assess the success of treatment. My role as a physician scientist, involved with both clinical and laboratory research, provides the opportunity to engage in an individualized and innovative approach to their treatment. Recently, my research team performed evaluation of cancer cells prior to completion of gynecologic surgical procedures. We found that it was possible to measure whether a patient still had cancerous cells and, thus, possibly help determine long-term outcomes.
In another study, we tested how often cancer patients were using our genetic counseling program, an advanced and often misunderstood arena of scientific inquiry.
We found that between 2010 and 2012, 832 patients were referred to our genetic counseling program, and 542 became new patients. Although not all patients went through with the genetic counseling, those who did gained valuable information about the presence of the recently infamous BRCA gene mutation, or their hereditary risk for colon or uterine cancer.
Armed with this knowledge, we were able to better personalize their care, and we hope to understand how this information can be useful in the future, as well to their families.
It is the nature of science that as it discovers one answer, it raises a dozen more questions. At Danbury Hospital, we do it with private donations rather than federal government funding. As we stumble in the darkness of inquiry, we are turning on the lights one at a time.
As Washington fails to provide the leadership necessary to move medical care forward, community hospitals such as Danbury will continue to light the pathway toward better health.
Dr. Shohreh Shahabi is the chairman of the Tumor Biology and Research Laboratory and the Department of Obstetrics and Gynecology at Danbury Hospital, a part of the Western Connecticut Health Care Network.
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