Should My Mum Receive Chemotherapy through Private or Public Hospital?

Lpizzapocket on 13/07/2020 - 15:27
Last edited 15/07/2020 - 16:24

I would like some insight into anyone's experience or knowledge of chemotherapy (comfort, price, reliability etc.) through either private or public hospitals (in Brisbane).

With absolutely no symptoms, my 60yo mum was diagnosed with stage 4 cancer over the weekend.

This is just extra information:

Her sister recently passed away from terminal breast cancer, so my mum decided to be proactive and have few things checked herself. As part of ovarian cancer screening, the GP found abnormality in her CT scans/blood test. The GP requested urgent colonoscopy through a nearby private hospital with appointment that was almost 4 weeks away. We requested a faster appointment with a specialist and so GP sent through multiple request to private and public hospital and we were able to have an appointment with a private hospital specialist where we had an initial appointment (around $100 gap was paid after medicare rebate).

For her colonoscopy and endoscopy a week later, it costed out of pocket $150 for anesthesia and $500 for the procedure. Mum's Medibank Private health insurance covered the rest - so I think it was about 50~60% that was covered by the private health insurance. She had additional CT scan and blood test done that day but I'm not sure if that was covered by anything as I had not received any invoice.

She'll be having keyhole procedure to biopsy the growths that were found to be spread throughout her abdomen as the doctor is unsure of what cancer this is (he thinks is a rare peritoneum cancer). The doctor was unable to get a biopsy in the initial colonoscopy. He advised that after they know exactly what cancer it is, mum will be able to start her chemotherapy.

As my family has been quite healthy, we've never had to go to the hospital in Australia and with my late aunt that passed away, she received chemo overseas so I'm not too sure what to expect.

So I guess my questions are:
-Is there a huge difference between private and public hospitals for a cancer patient, including chemotherapy? In terms of price, comfort, reliability, availability of appointments? My mum only speaks basic English just as a side note.

-Also, should we be getting second advice from a different specialist?

I don't even know if I'm asking the right questions to be honest. Just devastated right now.

Thanks OZB

Health & Beauty

Comments

  • [Deactivated] on 13/07/2020 - 15:46
    +1

    Private is just fancier, but they all have standards.

    Go to whichever your mum gels with better, hospitals all have their own cultures.

    • IVI on 13/07/2020 - 16:08
      -6

      Are you aware of IMMUNOTHERAPY?

      A friend w/ Lung Cancer managed to pivot away from Both
      Chemo' & Radiation' in favor of Immuno'

      It may well be worth exploring…

      • YesPleaseThankYou on 13/07/2020 - 16:14

        Good to have options, but best discussed with a medical professional.

        • IVI on 13/07/2020 - 16:31
          +1

          Agreed.

          See below (in my larger post) for info that doesn't always get conveyed to women before age 40…

          All Women should be advised (before age 40) whether they have "dense" breasts…
          I leave it to Dr Rhodes to tell 'em Why (in her TEDxWoman talk)

  • YesPleaseThankYou on 13/07/2020 - 15:52
    +3

    I'll keep it brief:

    1. In the event of serious illness, you want the best medical care, and you want choices. Keeping the private health insurance (PHI) active gives your mum those choices. Rightly or wrongly, there are some specialists that decline to see patients who do not hold PHI. (The general argument for this seems to be that the doctor can immediately move the patient to their preferred private hospital and do what they need to do. The same isn't generally available for a non-PHI patient, unless they can demonstrate their ability to pay.)

    2. There are good doctors and bad doctors in both the public and private systems. You want that choice, you want the best of the best in the current circumstance. Start asking around.

    3. You should always get at least one second opinion. Get a referral as soon as possible.

    4. Some PHI includes a free second opinion service (outsourced to a third-party provider). Medibank is not one of those insurers.

    I wish your family the best in this time.

    • IVI on 13/07/2020 - 16:11

      A specialist, who foregoes seeing any groups of patients might eventually become a bit "Less than the Best" if they miss too many opportunities to see & treat all available "cases," that may come their way.

      • YesPleaseThankYou on 13/07/2020 - 16:13
        +1

        I have no opinion on your statement. Just stating my understanding of how it is.

        At this time, the OP needs information and options.

        • IVI on 13/07/2020 - 16:34

          Agreed. I was speaking statistically…

          See below for a medical Dr (& cancer researcher's advice)

      • IVI on 13/07/2020 - 16:26
        -3

        Oh, if it's Breast' everyone in your family & others, too… should
        be told (eg, on their 1st Mammogram) whether they have "dense"
        breasts (if they Do, they'll need [non-Mammogram] scan, fr age 40):

        See this comprehensive, if dated, TEDxWomen talk for details:

        • Dr Deborah Rhodes' "Deborah Rhodes: A test that finds 3x -more- breast tumors"

        She co-invented the Molecular Breast Imaging (MBI) machine:

        "Working with a team of physicists, Dr. Deborah Rhodes developed
        a new tool for tumor detection that's 3 times as effective as traditional
        mammograms for women with dense breast tissue.

        The life-saving implications are stunning.

        So why haven't we heard of it? Rhodes shares the story
        behind the tool's creation, and the web of politics and
        economics that [kept] it from mainstream use."

        Update: The MBI machine is now available [at the Mayo' etc.]

        "Deborah Rhodes is an expert at managing breast-cancer risk.

        The director of the Mayo Clinic’s Executive Health Program is
        now testing a gamma camera that can see tumors that
        get missed by mammography."

        She's a Physician & cancer researcher

    • pizzapocket on 15/07/2020 - 16:23
      +1

      Thank you so much for providing your response - it has been more than helpful. Taking everyone's comments, I have talked to mum's GP and have been reading up on what would exactly be covered and how much, if we go the PHI route - but at the same time, you have made a valid comment about how there are good and bad doctors in private and public systems. I'll be doing my research!! Thank you again.

  • Snake 4 on 13/07/2020 - 16:30
    +1

    immunotherapy is only used on six types of cancers. Colon cancer is mot one of them.

    It also has considerable side effects.

    https://www.google.com/search?client=firefox-b&ei=B_0LX6jFAb…

    https://www.cancer.gov/about-cancer/treatment/types/immunoth…

    • IVI on 13/07/2020 - 16:37
      -4

      Tnx, 'didn't know that… my friend may have got it in a clinical trial
      (and - assuming it was a "gold standard" …ie, double blind trial),
      it's at least possible, that she got placebo."

  • screensaver on 13/07/2020 - 16:41

    Go ahead with this procedure, keep copies of everything, especially test results, and scans ,get second opinion, takes all results

    • YesPleaseThankYou on 13/07/2020 - 22:13

      It's important to remember that a patient is legally entitled to a copy of their medical records.

      It's often easier to collect these as you go than to make a request later on.

    • pizzapocket on 15/07/2020 - 16:18
      +1

      I have now asked for copies of everything! Thank you for your advice. I think I'm now getting a grasp of how to handle admin side of things for mum :)

  • [Deactivated] on 13/07/2020 - 17:11
    +2

    Private - better room and choice of doctors/surgeon. Better continuity of care (and associated quality of care due to continuity).

    Public - shared rooms, whichever doctor/surgeon is rostered (often these doctors also work in private) and more down time as appointment times would not be as flexible.

    The standards here are really high and clinicians, public or private, have to conform to the same standards and bound by the same laws.

    • pizzapocket on 15/07/2020 - 16:16

      That's very helpful to know! After reading the comments, I have contacted mum's GP who has also made the same comment and has recommended receiving treatment through a public system as most things will be covered.

    • tight-ass on 16/07/2020 - 16:38
      +1

      The statement above isn't 100% accurate.

      We have private health insurance & I opted to be treated as a public patient. I was advised everything was the same (public vs private patient - rooms, staff, food etc).

      Private patients don't always get their own room. I had 3 stays in hospital all up for my cancer surgery & had a private room the first 2 stays and a shared room on the 3rd stay.

      For the chemo treatment however I opted to be processed as a private patient. There's a big difference between public / private treatment. Much nicer facilities, higher staff to patient ratio & your own Oncologist for the duration of your treatment. Public patients get whichever Oncologist is available on the day.

      I would definitely be opting to have Chemo as a private patient. Especially in the current COVID-19 situation - the private chemo treatment centres are generally separate to the hospital or located elsewhere so less interactions with other (mostly sick) people. You need to be really careful during chemo as your immune system will be compromised.

      • [Deactivated] on 16/07/2020 - 17:21

        Obviously there is variation between hospitals.

        There is no reason why a public hospital would carry higher risk of covid infection than a private one.

        Public hospitals have protocols and resources to ensure high risk patients do not share anything with potential covid patients.

        Private hospitals/practice may continue accepting patients as they are financially driven. I'm not saying they are necessarily taking bigger risks for financial gain but there certainly is an incentive.

        So I stand by my summary of private vs public - apart from wait times for elective procedures, it's purely a comfort thing.

  • Alan Laz on 13/07/2020 - 17:38
    +2

    As a Victorian my answer would be - get to Peter Mac as quickly as possible, your GP may need to refer
    I'm sure Queensland has similar standards of care

    In Melbourne, Peter Mac operate a cancer treatment centre at Moorabbin hospital, may be others too

    All decent specialists operate in and around the major public hospitals.

    My mother had stage 4 cancer and was treated at no charge, successfully, through the excellent public hospital system.
    Worth mentioning that the treatment at Peter Mac was endlessly polite sympathetic and empathetic. Lovely.

    • pizzapocket on 15/07/2020 - 16:14
      +2

      Hi Alan, I hope your mother is in better health condition now. We are considering taking the records/scans/notes from the private hospital to receive treatment at a public hospital. Seems like there is not much of a difference between the two.

      • Alan Laz on 17/07/2020 - 13:20

        Answering wrong question

    • Alan Laz on 17/07/2020 - 13:19

      Important update - she is in rude health now

      We are endlessly indebted to the lovely folks at Peter Mac, City and Moorabbin

  • try2bhelpful on 13/07/2020 - 18:55
    +2

    First of all I wish your mother, and you, all the best with this.

    My first port of call would be to go back to my GP and have a chat about the diagnosis and the options; see if he/she thinks a second opinion would help. Fortunately my brilliant GP spotted my melanoma before i needed chemo so, in my case, they took a chunk out of my arm, patted me on the head and told me to do the checkups; that was 20 years ago now. In my case everything was done in a public hospital and it all worked out well. Be aware that if she is being treated in a private hospital, and something goes wrong, they will admit her and she will be up for bed costs as well. The GP can, probably, explain what your level of health cover will enable you to do. My other half needed an Angiogram, that morphed into a stent operation, and the GP checked his “Rolodex” for someone who he trusted who was willing to work in a public hospital; it went really well.

    This is an awful time, just help your mother to steer her way through this as she will be in shock.

    • pizzapocket on 15/07/2020 - 16:12

      Thank you for sharing your experience. After reading everyone's comments, I have called the GP yesterday and we did discuss some things to consider. I getting a good grasp of where to ask for advice now :)

  • CheapskateQueen on 13/07/2020 - 20:53
    +3

    I really don't have an answer for you, I'm sorry about your mum's diagnosis.

    My mum has a serious illness (not cancer). At the end of the day, we all just want the best doctor in hopes that means the best treatment. We were referred to a particular specialist, and I took her there as a private patient and paid for the consults and any tests. Once we got herdiagnosis, her monthly treatment is in public hospital and all hospital treatment is free. There wouldn't be any difference in actual treatment between private/public hospital. it's all the same meds. Worst case is we/she had a few long days of waiting, but there's a rhythm now.

    I guess we're lucky that the specialist is in both private/public system. We still see the specialist privately for regular progress updates and to manage her treatment/make decisions.

    My point is, first focus on finding a doctor that you're comfortable with. If you have the ability to pay for the first few consults/ tests (quicker than public), maybe that's the way to go. Then find out what the treatment options are and whether the public/private system is the same treatment wise. I suspect it is. You might be able to mix it up, like we do.

    I think some things in life you have to go private and there are better options than public (especially with implants and newest technology), but i don't think public system should always be seen as inferior.

    If there was a doubt in my mind about the treatment my mum gets, we'd be going private for sure.

    • YesPleaseThankYou on 13/07/2020 - 22:12
      +1

      Just a small point of note:

      PHI is not permitted to reimburse a patient for in-room consultation fees. The patient will need to pay those and claim back from Medicare. If the patient reaches the Medicare Safety Net, then from that point Medicare will rebate a higher proportion of the consultation fee paid.

      Absolutely the doctor matters, as you say, find one that you're comfortable with, and one who knows his or her stuff.

      • pizzapocket on 14/07/2020 - 08:40
        +1

        I was wondering why the receptionist did not put the initial consult through mum's PHI. I didn't know about this! Thank you this information :)

    • pizzapocket on 14/07/2020 - 08:38
      +1

      I think this is exactly the response I was hoping to see and confirm whether combination of private/public system was possible. I will be calling up my mum's GP to see if we can get another referral to a public hospital (I naively cancelled her appointments with the public hospital at mum's request). I think I've read here or through googling that chemo is covered under PBS through public system, and the cost of chemo through private - I'm still to find out. Thank you for your valuable input. I hope your mum gets well soon.

      • CheapskateQueen on 14/07/2020 - 12:52
        +1

        glad it has helped, and yes, get the referral for public just in case.

        Also, feel free to ask them if there are "free" options for tests (as required). e.g. As a pensioner, mum could get free MRIs at certain places. At $300 a pop, and a convenient location, it was worth me leaving work early to take her… especially since I like being there for moral support anyway.

        For something like cancer, I imagine a huge amount of subsidised/free treatment/tests are available. Don't be shy to ask. It's why we all pay Medicare all our lives.

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