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Discussing procedure costs with patients increases transparency
There is value in a physician being transparent with patients about elective procedure costs in this climate of value-based medicine.
Traditionally, surgeons are not expected to discuss the costs of a procedure with their patients. Instead, they discuss the risks, benefits and alternatives of a surgery with patients before handing them off to a staff member to discuss costs, OSN Refractive Surgery Board Member Jason P. Brinton, MD, said.
“I’ve heard it cheapens a procedure for a doctor to discuss cost. That may have been the case in the past, and I’m sure my grandfather would have felt that way when he began practicing ophthalmology in St. Louis in the 1940s, but with lifestyle medicine, the consumer is more empowered today than they have been in the past. They know it’s a question, and I think our patients want us to acknowledge it briefly and be clear about it,” Brinton told Ocular Surgery News.
With changes in insurance, the health care industry has experienced a massive shift that has led to a rise in cost-sharing with patients. With the advent of high-deductible health plans and increased cost-sharing, patients have become more sensitive to the question of value, Brinton said.
Changing medical landscape
Lifestyle medicine — medicine that does not heal a sickness but improves function and performance — is compelling patients to make more value-based decisions with their health care.
“In the world of elective lifestyle medicine, patients carefully consider both medical factors and cost factors, as with the cost of LASIK or refractive lens exchange. For previous generations of patients, insurance was expected to pick up the tab for a procedure, shielding the patient from financial questions and creating what economists call a moral hazard. But now in addition to the medical questions, there are important value considerations. If I am a candidate, is this a lifestyle benefit that I value sufficiently?” Brinton said.
More than a decade ago the prevailing opinion among surgeons was to only discuss the medical aspects of a procedure. Clinic staff members were expected to discuss finances with a patient, Brinton said. Surgeons were taught to avoid these questions and to separate medicine from expenses.
“I agree that risks, benefits, alternatives and candidacy determination all come first, but is that where doctors should stop?” Brinton said.
Young patients expect transparency
Patients are aware that surgeons know how much their procedures cost; it is comforting to patients when a doctor is open about this, according to Brinton.
“There is value in a physician who can be forthright with a patient. We don’t go into a lot of details. We don’t spend time talking about payment options or financing, but there’s value in a physician being transparent and saying this is what our cost is and this is the value that we hope to attain for that cost,” he said.
Brinton stages the medical conversation first and then the cost conversation.
“We answer all of their medical questions and then discuss financial concerns if they have any,” Brinton said.
Some may find this shift in practice uncomfortable, but with today’s younger generation seeking LASIK, SMILE and Visian ICL (STAAR Surgical), the discussion is well received, he said. – by Robert Linnehan
- For more information:
- Jason P. Brinton, MD, can be reached at Brinton Vision, 555 N. New Ballas Road, Suite 310, Saint Louis, MO 63141-6896; email: jbrinton@brintonvision.com.
Disclosure: Brinton reports no relevant financial disclosures.