Yesterday at work, one of my colleagues entered the physician workroom raving about Angelina Jolie’s Op-Ed published in the New York Times. I hadn’t read it until this morning, but by now most of you have heard that she openly discussed her decision to have prophylactic bilateral mastectomies after testing positive for the BRCA1 gene. Toward the end of her opinion piece, Ms. Jolie acknowledged that the cost of the genetic test would be prohibitive to many women.
The Op-Ed highlights several important issues relevant to the discussion of socioeconomic status (SES) and its impact on health. Last week, my blog briefly highlighted the 3 components of SES – education, income, occupation – and introduced the concept of functional illiteracy. SES impacts your ability to seek appropriate and qualified specialty care.
Some folks are unaware that they can seek a second opinion or see a specialist! Yet as Ms. Jolie’s Op-Ed alluded to, medical care can be costly. Some insurers charge a higher co-pay to see a specialist or may not cover visits outside of a particular hospital network. I see this often in Boston; patients being told they cannot come to see me at Mass General Hospital because their insurance won’t cover it! Yet I have patients who have financial means and are willing to pay higher out-of-pocket fees to come to a specialized cancer center for their care.
Money matters!!
The Op-Ed highlights several important issues relevant to the discussion of socioeconomic status (SES) and its impact on health. Last week, my blog briefly highlighted the 3 components of SES – education, income, occupation – and introduced the concept of functional illiteracy. SES impacts your ability to seek appropriate and qualified specialty care.
Some folks are unaware that they can seek a second opinion or see a specialist! Yet as Ms. Jolie’s Op-Ed alluded to, medical care can be costly. Some insurers charge a higher co-pay to see a specialist or may not cover visits outside of a particular hospital network. I see this often in Boston; patients being told they cannot come to see me at Mass General Hospital because their insurance won’t cover it! Yet I have patients who have financial means and are willing to pay higher out-of-pocket fees to come to a specialized cancer center for their care.
Money matters!!

Think about it: If you or your family member are considering major surgery for a diagnosis of breast cancer, would you want to see a surgeon who specializes in surgery for patients with breast cancer or would you be comfortable seeing a general surgeon who may treat a variety of ailments but might not perform many oncologic procedures??
Income, or lack thereof, can limit screening and treatment options. It also impacts the decisions patients make about their treatments! Ms. Jolie is fortunate enough to have a job that enables her to take time off for an elective surgery - she may be in a position to not have to work again; she has the means to pay someone to help care for her six children and clean her multiple homes; can hire a chef to create nutritious meals that will speed her recovery.
Cash flow impacts access to healthcare providers AND ability to access care for your health.
Yes, this Op-Ed brought attention to genetic testing, an issue that affects a very small number of women (will discuss genetic risks and breast cancer in a subsequent post), but I don't know that it is worth raving about.
~One drop of knowledge can ripple through an entire community
Income, or lack thereof, can limit screening and treatment options. It also impacts the decisions patients make about their treatments! Ms. Jolie is fortunate enough to have a job that enables her to take time off for an elective surgery - she may be in a position to not have to work again; she has the means to pay someone to help care for her six children and clean her multiple homes; can hire a chef to create nutritious meals that will speed her recovery.
Cash flow impacts access to healthcare providers AND ability to access care for your health.
Yes, this Op-Ed brought attention to genetic testing, an issue that affects a very small number of women (will discuss genetic risks and breast cancer in a subsequent post), but I don't know that it is worth raving about.
~One drop of knowledge can ripple through an entire community