Why the Hippocratic oath needs 'do no financial harm'

The Hippocratic oath requires physicians to abstain from doing harm--but does that include financial harm?

With medical bills as the number once source of personal bankruptcy, teaching hospitals are encouraging students to consider health costs, the Chicago Tribune reported.

Some, including the University of Chicago's Pritzker School of Medicine, want to take it a step further and add "do no financial harm" to the Hippocratic oath.

Vineet Arora, an assistant dean and associate professor of medicine, is developing training videos to make medical students more aware of how the costs of their decisions will affect patients.

"We are totally insulated from price, what medical care actually costs the patient," Andrew Levy, a recent med school graduate who is working with Arora, told the Tribune. "I can't tell when a test I order becomes a bill or if and when my patient gets charged by it, and that's absurd."

Medicals schools already have started incorporating cost control into future doctors' curriculum, according to first-year Harvard Medical School student Ilana Yurkiewicz. But in her Scientific American blog post, she acknowledged that it may be more difficult to include cost in decision-making when face-to-face with patients than during hypothetical scenarios in a classroom.

Moreover, cost considerations can become a slippery slope between reducing unnecessary medical costs and rationing care. So healthcare educators emphasize teaching medical students to look for alternatives that their patients can afford, the Tribune noted.

However, it's not only prospective doctors that can benefit from cost awareness. Reminding practicing physicians how much money blood tests cost could cut unnecessary medical spending, according to a study published last year the journal Archives of Surgery.

For more:
- read the Tribune article
- here's the Scientific American blog post