3 tips for discussing cost of care with patients

As we've reported previously, doctors can no longer ignore the elephant in the exam room: Patients' personal expense for care. According to some experts, doctors face not only ethical reasons but possibly a legal obligation to tell patients what the care they provide will cost.

Nonetheless, money can be a touchy topic of conversation anywhere, especially in the doctor's office. A recent article from American Medical News provided the following tips for making such talks more comfortable and productive:

  1. In cases in which you're recommending against a test or procedure a patient requests, speak to patients in nontechnical language, and, if possible, provide the patient with literature on the subject or read it together at the Choosing Wisely website, suggested Glen Stream, M.D., board chair of American Academy of Family Physicians.
  2. Address patients' finances in an authoritative, matter-of-fact way that will not feel intrusive, advised Mark Hall, professor of law and public health in the Division of Public Health Services at Wake Forest University in North Carolina. "Do not ask about ability to pay, but the extent of their insurance coverage," Hall said.
  3. Use a deferral strategy for costly services that aren't urgent, such as an MRI for pain that's existed for just a few days. "Tell the patient it doesn't make sense to have this procedure at this time, but it might make sense later. Tell them to come back in a couple weeks, and if it's worse, we'll check it out," suggested Susan Dorr Goold, M.D., a professor of internal medicine at the University of Michigan Medical School who has studied patients' treatment decisions in light of cost.

To learn more:
- read the article from American Medical News

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