Success in the medical world requires more than a highly trained, masterfully skilled and fully informed physician. It also requires a fully informed patient. When a patient is never forced to exclaim, “If only I had known,” the doctor-patient relationship flourishes and health care reaches its full potential.

That’s why we applaud state Rep. Jim Moeller, D-Vancouver, for introducing a bill in the Legislature that would lead to more fully informed breast-cancer patients. House Bill 1101, which has been advanced by the Health Care & Wellness Committee to the House floor, would require physicians “to inform patients undergoing a mastectomy, a lymph node dissection, or a lumpectomy about options for reconstructive surgery.” National studies have revealed why this is necessary: Fewer than 30 percent of women who undergo breast cancer surgery also choose reconstructive surgery. Racial minority groups show even lower percentages. In many cases, the women patients simply don’t know what’s available or, even more troubling, they don’t know that reconstructive surgery is covered by their health insurance plans.

Fortunately, though, state and federal laws require health insurance plans that cover mastectomies to also cover reconstruction surgery. So this is not a case of convincing politicians to change any of their practices or convincing health insurance companies to do the right thing. All of that is already happening. It’s simply a case of making sure patients with breast cancer are fully informed, and we don’t see how any reasonable person could oppose knowledge, especially when it’s transmitted between doctors and patients.

Moeller got the idea for his bill from a surgeon at Vancouver’s Southwest Washington Medical Center, which is one of the leaders in breast reconstructive surgery, drawing patients from throughout the state and beyond. Dr. Allen Gabriel directs the hospital’s plastic surgery department, and he has made available an abundance of information on this subject at the website http://www.pinklemonadeproject.org. After Moeller learned from Dr. Gabriel about the knowledge gap between patients and the post-mastectomy solutions, HB 1101 began to take shape. Among co-sponsors of a companion bill in the Senate — SB 5262 — is state Sen. Craig Pridemore, D-Vancouver. We hope Moeller’s and Pridemore’s colleagues become fully aware of the need for this new requirement. It would cost the taxpayers nothing, and ought to rank among all physicians as a purely automatic conversation with patients.

In that conversation, if this bill passes, breast-cancer patients would be told about various reconstructive options and the advantages and disadvantages of each, including a statement that reconstruction might not be appropriate for all patients. The patients also would be told about the laws that require insurance coverage.

We like this bill because it would keep the doctor in charge. It protects the privacy of that one-on-one relationship. Dr. Gabriel recently described the surgery in an interview with The Columbian: “Even though it’s considered an elective surgery, it’s covered like any other procedure that is considered a medical necessity. You can’t discriminate.” His insight helps explain why New York passed similar legislation last year and why Texas and New Mexico are considering doing the same thing.

Requiring doctors to fully disclose vital information — and giving patients full access to solutions they may pursue — makes perfect sense.

Print this article