Recently a Boston Globe article http://www.bostonglobe.com * noted: “This patient could be a time bomb, Dr. Neel Shah thought. A blood test suggested that she might have an ectopic pregnancy, in which a fertilized egg remains outside the uterus. Left untreated, the condition can cause fatal hemorrhaging. But when Shah, a medical resident at the time, told the woman she needed an ultrasound to confirm the result, she refused. An earlier visit to the emergency room for a bout of stomach trouble had left her with an exorbitant bill. Until Shah could tell her how much an ultrasound would cost, she wasn’t budging.”
“He had no idea what an ultrasound cost, and it took him a day to find out from the hospital. “All the while I was worried she could bleed to death,” Shah says. After telling the woman the test would cost $650, she agreed to be scanned. Shah’s suspicion was confirmed and the woman was successfully treated.”
“Shah, now an obstetrician at Beth Israel Deaconess Medical Center, tells this story to illustrate what he sees as two entwined realities in modern medicine. One is that doctors often have no idea how much treatments cost. The other is an emerging notion with the potential to change how physicians practice medicine in the United States: that medical costs themselves can harm patients’ health. Shah is part of a growing movement of American doctors who argue that it’s time for physicians to start considering costs in their practice, weighing the toll of medical debt against the benefit of expensive treatments, and talking to their patients directly about money.”
“In America’s current health care debate, any mention of cost-consciousness in the doctor’s office evokes concerns about rationing, denial of care, insurance companies pushing for cheaper over better. Doctors themselves have long embraced an ethical responsibility to advocate for the best possible treatment for their patients, regardless of price, and their patients count on that philosophy to guide their decisions. But Shah and others say that ignoring cost has become a luxury doctors can no longer afford—one that not only contributes to the unsustainable growth of health care budgets, but also can end up damaging patients’ lives. They are asking their colleagues to become aware of how their treatment choices can lead to financial harm—or, as some call it, “financial toxicity,” a new term for the myriad negative effects that high medical costs can have on patients’ well-being.”
* to read the full Boston Globe article “Should doctors consider medical costs?” by Timothy Gower highlight and click on open hyperlink http://www.bostonglobe.com/ideas/2014/04/12/should-doctors-consider-medical-costs/GPJM1h30qtz6zpfzrxQGoL/story.html
Doctor, Did You Wash Your Hands? ™ provides information to consumers on understanding, managing and navigating health care options.
Jonathan M. Metsch, Dr.P.H., is Clinical Professor, Preventive Medicine, Icahn School of Medicine at Mount Sinai; and Adjunct Professor, Baruch College ( C.U.N.Y.), Rutgers School of Public Health, and Rutgers School of Public Affairs and Administration.
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