BACKGROUND: Though many patients and physicians believe that they should discuss out-of-pocket costs, research suggests that they infrequently do. OBJECTIVE: To examine barriers preventing patient-physician communication about out-of-pocket costs among study subjects recalling a time when they wanted to discuss these costs but did not do so. DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional surveys of 133 general internists and 484 of their patients from 3 academic and 18 community practices in a large midwestern metropolitan region. MEASUREMENTS: Patient- and physician-reported barriers to discussing out-of-pocket costs. MAIN RESULTS: Overall, 54 patients (11%) and 27 physicians (20%) were able to recall a specific time when they wanted to discuss out-of-pocket costs but did not do so. Among patients, a wide variety of barriers were reported including their own discomfort (19%), insufficient time (13%), a belief that their physician did not have a viable solution (11%), and concerns about the impact of discussions on quality of care (9%). Among physicians, the most common barriers reported were insufficient time (67%) and a belief that they did not have a solution to offer (19%). CONCLUSIONS: Efforts to promote discussions of out-of-pocket costs should emphasize the legitimacy of patients' concerns and brief actionable alternatives that physicians can take to address them.
BACKGROUND: Though many patients and physicians believe that they should discuss out-of-pocket costs, research suggests that they infrequently do. OBJECTIVE: To examine barriers preventing patient-physician communication about out-of-pocket costs among study subjects recalling a time when they wanted to discuss these costs but did not do so. DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional surveys of 133 general internists and 484 of their patients from 3 academic and 18 community practices in a large midwestern metropolitan region. MEASUREMENTS: Patient- and physician-reported barriers to discussing out-of-pocket costs. MAIN RESULTS: Overall, 54 patients (11%) and 27 physicians (20%) were able to recall a specific time when they wanted to discuss out-of-pocket costs but did not do so. Among patients, a wide variety of barriers were reported including their own discomfort (19%), insufficient time (13%), a belief that their physician did not have a viable solution (11%), and concerns about the impact of discussions on quality of care (9%). Among physicians, the most common barriers reported were insufficient time (67%) and a belief that they did not have a solution to offer (19%). CONCLUSIONS: Efforts to promote discussions of out-of-pocket costs should emphasize the legitimacy of patients' concerns and brief actionable alternatives that physicians can take to address them.
Entities:
Keywords:
Empirical Approach; Health Care and Public Health; Professional Patient Relationship
Authors: Derjung M Tarn; Thomas J Mattimore; Douglas S Bell; Richard L Kravitz; Neil S Wenger Journal: J Am Geriatr Soc Date: 2012-05-30 Impact factor: 5.562
Authors: Jeffrey T Kullgren; Alison A Galbraith; Virginia L Hinrichsen; Irina Miroshnik; Robert B Penfold; Meredith B Rosenthal; Bruce E Landon; Tracy A Lieu Journal: Arch Intern Med Date: 2010-11-22
Authors: Ashra Kolhatkar; Lucy Cheng; Steven G Morgan; Laurie J Goldsmith; Irfan A Dhalla; Anne M Holbrook; Michael R Law Journal: CMAJ Open Date: 2018-11-19
Authors: Katherine H Schiavoni; Lisa Soleymani Lehmann; Wendy Guan; Meredith Rosenthal; Thomas D Sequist; Alyna T Chien Journal: J Gen Intern Med Date: 2016-08-25 Impact factor: 5.128