The Cost of Medical Care

I’ve had the opportunity to be a patient this summer. Many physicians have written about their experiences “on the other side” (for some interesting recent writings, see these by Rebecca Crow, Eric Manheimer as well as an interview with Robert Klitzman or his book, “When Doctors Become Patients”). I’m not going to tread that same ground except to say that I could corroborate moments of depersonalization, while also recognizing that most of the time I was getting special treatment because I am a physician. This didn’t come as too much of a surprise to me, having had a hospitalization for orthopedic surgery when I was a medical student. But there is one aspect of this experience, despite feeling like it is something that I have been giving attention to as a physician, and about which I take responsibility for teaching our residents, that caught me completely off guard: the cost of care. It sounds crazy to even say this out loud, with all of the attention that has been given to healthcare costs in the wake of healthcare reform. And it is not like I haven’t heard that medical costs are the most common reason for personal bankruptcy in this country, or haven’t seen the choices our patients must sometimes make between medicines/tests or other essential expenses for daily living (also outlined in this Annals of Family Medicine article). It’s just fascinating what the impact of personal experience can be.

So I wonder, am I doing enough? I will continue to teach about High Value Care. I will try to Choose Wisely. I will continue to support the efforts of ACP and other organizations to help our patients get access to affordable healthcare. But what about addressing the actual price of care? While it is not easy to get the data, we clearly pay more in this country for the same service compared to other countries. It will be interesting to see who has the political will to address this.

While it is not exactly in the same vein, I was prompted to write about the topic of healthcare costs by this article that just appeared in Politico by Katie Jennings about the RUC, the AMA committee that advises CMS about how to set physician reimbursement.

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