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Shortly after the rollout of the new healthcare exchanges, we asked the members of ONCOLOGY’s Editorial Board to share their impressions of what they were seeing-and what they expected to see-in terms of the effects of the ACA on practicing oncologists and their patients.

Although the room was dark, the moon streaming through the windows cast uneasy half-shadows on the carpet. The only sound was the rhythmic ticking of a mantel clock. As I peered in into the gloom I was startled by a thin woman, wrapped in lace, standing across from me.

If payments were bundled, we would be accountable to evaluate our treatment plans, follow-up visits, tests, and imaging. We need a system that rewards us for excellent care and allows the costs to be presented to our patients.

In a case of a patient with impaired decision-making, is the physician obligated to go through with a transplant when the transplant-related mortality would be on the order of 50%, and possibly as high as 80%?