Docs want to inform patients about cost—but don’t have the time or tools

A new survey from University of Utah Health revealed that most physicians feel responsible for educating patients about the cost of care but don’t believe they should be held accountable for it.

“We found that while clinicians feel a great sense of responsibility around keeping costs affordable for patients, they don’t feel they have the tools to know, the time to discuss, or the ability to impact how much things cost,” wrote the authors of the report, which was published online by NEJM Catalyst on July 10.

The analysis featured 571 online surveys from the NEJM Catalyst Insights Council, which includes healthcare executives, clinical leaders and clinicians.

Almost all respondents agreed out-of-pocket costs are important to patients. More than 60 percent believe physicians are responsible for educating patients about the cost of care, but 53 percent of clinicians, 44 percent of clinical leaders and 32 percent of executives felt physicians shouldn’t be held accountable for those prices.

“Physicians don’t set pricing for insurance, and we can’t determine the price of a drug or a new technology, so it’s easy to feel powerless when it comes to impacting costs,” said Robert Glasgow, MD, vice chair of clinical and quality operations for University of Utah Health’s Department of Surgery. “In an ideal state, all stakeholders would be accountable for costs.”

When considering which stakeholders had a “strong impact” on healthcare costs, most respondents cited pharmaceutical/biotech companies (87 percent), health plans and insurers (81 percent) and hospitals/health systems (75 percent). Less than 30 percent of respondents thought individual clinicians, employers and patients had strong impacts on costs.

Supporting Glasgow’s point about powerlessness, 86 percent of respondents believe clinicians aren’t adequately trained to discuss the cost of care and 78 percent believe the tools to estimate costs for the patient aren’t available. Also, 64 percent of participants agreed there isn’t enough time to discuss costs with patients in the clinic.

The survey responses indicate physicians should play a role educating patients about costs, but clinicians may still lack the tools and training to do this effectively.

Still, Glasgow cautioned that finesse is needed for these discussions, and said dollar amounts shouldn’t always be front and center.

“The doctor-patient relationship should never be seen as a business transaction,” he said. “We need to train physicians to give patients enough cost data. That’s the starting block of high-value care.”