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Docs Should Discuss Out-of-Pocket Costs With Patients
Patients should be informed of costs and allowed to consider cheaper alternatives, get assistance

THURSDAY, Oct. 17 (HealthDay News) -- Given the high out-of-pocket costs associated with health care and their implications for patients, physicians should discuss these costs with patients during the clinical decision-making process, according to a perspective piece published in the Oct. 17 issue of the New England Journal of Medicine.

Noting that health care providers often don't discuss potential costs before ordering diagnostic tests or making treatment decisions, Peter A. Ubel, M.D., from the Duke University Medical Center in Durham, N.C., and colleagues discuss the impact of these out-of-pocket costs for patients.

Based on examples of overwhelming costs in cancer care, diabetes, and myocardial infarction, the authors discuss the distress caused by health care-related financial burden. Many insured patients are required to reduce spending on food and clothing to afford out-of-pocket costs, or reduce the frequency with which they take the prescribed medications. Discussing out-of-pocket costs is a crucial aspect of clinical decision making. Discussing these costs allows patients to choose lower-cost alternatives, when available, and consider the trade-off between cost and potential benefit. Knowing the out-of-pocket costs can also allow patients to seek financial assistance in advance. Furthermore, evidence suggests that considering costs in clinical decision making may reduce costs in the long term.

"We believe that given the distress created by out-of-pocket costs, it is well within physicians' traditional duties to discuss such matters with our patients," the authors write.

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October 1, 2014

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