Talking Medical Costs? Trust in Physicians is Key | Healthcare Informatics Magazine | Health IT | Information Technology Skip to content Skip to navigation

Talking Medical Costs? Trust in Physicians is Key

July 25, 2013
by John DeGaspari
| Reprints
Good doctor-patient relationships facilitate discussions about medical costs

Strong relationships with physicians, particularly those that are long standing, are likely to increase patients' openness to talk about health care costs when decisions are being made about their treatment options, according to a study from the National Institutes of Health. Rushed visits with insufficient time to talk about important issues can undermine efforts to bring sensitive topics like costs into the doctor-patient relationship and can be counter-productive. The work appears online in the Journal of General Medicine.

As physicians are increasingly expected to take costs into account when they offer treatment recommendations and make decisions for patients. Several communication strategies have been considered to help doctors broach the topic of insurer and out-of-pocket costs with patients. These include:

  • Using empathy so doctors and patients are working as a team to address the issue of cost;
  • Each party doing their part to address costs so the decision-making is fair;
  • Emphasizing that the less expensive option is good enough and debunking the notion that the newest, most expensive treatment is the better choiicand Educating patients of the impact of rising health care costs on their premiums.

The researchers convened 22 focus groups of 211 insured patients to explore attitudes towards discussing and considering insurer and out-of-pocket costs in the doctor-patient encounter. They also examined whether proposed communications strategies would make the patient more receptive to discussing cost.

In the focus groups, patients were led though a series of scenarios. For example, patients were asked to imagine they had experienced the worst headache of their life for three months, for which their doctor recommended an imaging study, e.g., MRI or CT scan. The doctor explained that the difference between the two tests was marginal; the MRI however was twice as expensive as the CT. For all scenarios, participants discussed whether and how they would want their physicians to broach the topic of costs with them, and which treatment option they would ultimately choose. The researchers also observed participants' reactions to the four communications strategies.

Patients were more willing to talk to doctors about personal, out-of-pocket costs than insurer costs. Older and sicker participants were more willing to talk to their doctor about costs than younger and healthier participants.

Overall, patients did not endorse recommended communications strategies for discussing costs in the clinical encounter. In contrast, patients stated that trust in their doctor would make them more willing to discuss costs. Barriers to having those discussions included rushed, impersonal visits and clinicians who were insufficiently informed about costs.

The authors suggest that stronger efforts to educate the public about the importance, for their own sake, of controlling insurer costs is a possible strategy for enabling discussions about these costs.

Get the latest information on Health IT and attend other valuable sessions at this two-day Summit providing healthcare leaders with educational content, insightful debate and dialogue on the future of healthcare and technology.

Learn More

Topics

News

KLAS Research: Small Hospitals’ Buying Decisions Impacting EMR Market Share

A new KLAS Research report tracks shifts in electronic medical record (EMR) vendor market share among acute care hospitals, and finds that smaller hospitals are seeking technology solutions that meet their needs and limited budgets, and these contracts are making a mark on the EMR market.

Survey: Majority of Providers Predict Success for New Generic Drug Company, Project Rx

Back in January, four health systems, in consultation with the VA, announced a collaboration to develop a new, not-for-profit generic drug company. A survey has found that 90 percent of providers say they would become customers of the new venture.

Personalized Medicine Awareness Low Among U.S. Adults, Survey Finds

Genetics and personalized medicine are not top of mind for the general public in the U.S., according to a recent survey from GenomeWeb and the Personalized Medicine Coalition.

Industry Organizations Praise Senate Passage of VA Mission Act

The U.S. Senate on Wednesday passed, by a vote of 92-5, a major Veterans Affairs (VA) reform bill that includes health IT-related provisions to improve health data exchange between VA healthcare providers and community care providers.

NIH Issues Funding Announcement for All of Us Genomic Research Program

The National Institutes of Health’s (NIH) “All of Us” Research Program has issued a funding announcement for genome centers to generate genotype and whole genome sequence data from participants’ biosamples.

MGMA: Physician Compensation Data Illustrates Nationwide PCP Shortage

Primary care physicians’ compensation rose by more than 10 percent over the past five years, representing an increase which is nearly double that of specialty physicians’ compensation over the same period, according to the Medical Group Management Association (MGMA).