No,
really, it's not our fault. According to a study published last month by JAMA
Oncol, it is a myth that escalating health costs are driven by patients
“demanding” tests and treatments. It simply is not happening. Rather, it would
appear that responsibility for factors ranging from poor communication, to
“defensive medicine”, to deliberate overpricing of various tests, procedures
and medications, to manipulation and gouging by “big pharma” and outrageously
high medical malpractice premiums that providers must cope with, must be passed
on somehow. And like cancer treatment itself, it's cumulative. But in spite of
all that, no, no indeed, it is not the patient's fault!
The
JAMA Oncol investigation reports that in a study of over 5,000 patients with
various cancers, including some of the most severe, less than one in ten (8.7%)
asked for a particular treatment or intervention, and providers complied with most
of these (83%), finding them clinically appropriate. Of the few that were found
to be inappropriate, only seven (0.14%) were indulged. This is not a
significant driver of costs. If this is true in oncology, where the patient
stress level is very high and demands for anything and everything would be
expected, it’s even less likely for less severe conditions.
Point
two; it's not the Internet's fault either. Despite reports from some providers
that the ease with which patients can obtain information about their condition
and treatment options, is driving demand for excessive and expensive tests,
procedures, etc. But this is another myth. And this myth is very confusing to
patients, as we are constantly encouraged to bring lists of our concerns with
us to appointments. We are told to come to appointments prepared to make the most
of the short time we have with our providers. We are told that an informed
patient “chooses wisely” and questions the need for extra tests and treatments but
we are then blamed for doing our diligence, our lack of understanding what we
are asking for and about, and for driving up the costs of care.
The
fact is, that no matter how informed, misinformed, demanding or compliant a
patient may be, we are still in your CARE. Unless we have a medical degree
ourselves (and in the appropriate specialty, no less), we are always in a
subordinate and vulnerable position. So you need to explain things and take our
concerns seriously, not interpret them as threats. We want to be treated as
individuals who deserve to have a respectful relationship with the person who
helps us get healthy. Creating a collaborative relationship with patients will
lower healthcare costs, not inflate them.
Gaye
Hyre
