Are Doctors Just Clueless About Medical Costs?

A few years ago, concerned about a persistent cough that I had that just wouldn’t go away, my doctor prescribed me a round of Advair, diligently showed me how to inhale the Advair and sent me off to the pharmacy to pick up the prescription. Well, those of you who have ever used Advair probably know what happened when the pharmacist rang up the prescription. I almost had a heart attack then and there when charged almost $300 for the Advair diskus, which my doctor had not prepared me for, despite preparing me for what the Advair was and how to use it. So the question today is, do doctors just not think that healthcare costs are important or are they just clueless?

Ioana Baiu comments on the issue at KevinMD:

But in spite of the growing fluidity of the medical curriculum, it was baffling for most of us to enter the “real world” of hospitals and clinics and realize how little we knew. While we were quite familiar with the Krebs cycle, electrolyte imbalances, rare genetic mutations, the “high-tech” seemingly comprehensive medical school curriculum stopped short. During our clinical years, we realized that our knowledge of pathophysiology was dwarfed by our unawareness of the issues that are so saliently engrained in the lives of our patients.

Not a single medical student knew what a complete blood count test would cost, or how much a patient would be billed after a night in the intensive care unit. Yet, we took pride in knowing how to enter an order in the computer and interpret an abnormal test. We were naïve to think that our patients are “non-adherent” to medications, when in reality, they just couldn’t afford them and were too embarrassed to admit it. These issues were foreign to us.

The definition of a “good physician” has changed in the last few years. It is no longer sufficient to limit ourselves to medicine; we must learn to take a holistic approach towards helping our patients, and this includes a keen awareness that our best medical care could mean their bankruptcy. In the last few years, physicians started to recognize “pain” as a 5th vital sign, in addition to temperature, heart rate, respiratory rate and blood pressure. Perhaps it is time to consider “ability to pay for medical expenses” as a close-up runner to our list of vital signs, one that could easily increase your heart rate and make one short of breath.

Ability to pay for medical expenses should be a vital sign

Do you think that doctors are just clueless about medical costs? Tell us about it in our discussion forum!

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