There are lots of things we need to do to get healthcare costs under control in the United States. Critical to most of our efforts, however, is to get physicians to practice cost-conscious care. Here is a nice story on this topic, from Rebecca Plevin at KPCC public radio in California:
As regular readers of Impatient know, I’ve been on a mission recently to encourage consumers to talk with their doctors about health care costs.
Everyone I’ve spoken with for this series – patients on high-deductible health plans, patient advocates and a few doctors – agrees that through these conversations, patients and doctors can work together to potentially lower people’s out-of-pocket costs.
But as Duke University professor Peter Ubel points out, patients can only have so much influence over their doctors’ recommendations.
“One of the biggest limits to the power of health care consumerism – of patients to discipline the health care marketplace – is the fact that doctors make most of the medical decisions,” Ubel tells me.
He offers this example: If a patient goes to see a doctor for back pain, and the doctor recommends an MRI, the patient can shop around for the most affordable MRI. But, he says, “I, as a patient, might not know that I didn’t need any MRI.”
Convincing doctors to avoid ordering unnecessary tests, or avoid prescribing expensive brand name drugs when generic versions are available, requires a larger, cultural shift in health care. One health system in Northern California has developed a way to concretely change physicians’ behavior.
Could this be a model for a cultural shift toward more cost-conscious, high-quality care? (To read the rest of this article, please visit KPCC.)