opinion

Patient involvement is necessary to rein in health care costs

LETTER — Posted April 15, 2013

Print  |   Email  |   Respond  |   Reprints  |   Like Facebook  |   Share Twitter  |   Tweet Linkedin

Regarding “Internists call to end 'assault' on doctor-patient relationship” (Article, March 1): The attention of the American College of Physicians to the erosion of the doctor-patient relationship is exactly on target. The most potent assaults on this relationship are the risk-sharing models of health care reimbursement (accountable care and bundled care) that are so rapidly sweeping through the country.

A physician who is incentivized to reduce health care costs, and profits from doing so, cannot have only the patient's best interest in mind when entering an exam room. Motivated by a bigger bonus, or fear of being terminated for overspending, doctors inevitably will insert cost concerns into their clinical decision-making. Patients will catch on that the providers are benefiting by providing less care, and the death knell of the doctor-patient relationship will be realized.

Cost of care certainly needs to be part of the decision-making, but not without engaging the patient. A balanced approach to this discussion will have impact only if the patient has some “skin in the game.” Involving patients in this way will help reduce costs, encourage patients to be more aware of their health care needs and even incentivize them to make better lifestyle choices.

For the sake of cost control, the doctor-patient relationship and quality of care, the discussion on health care reform needs to move in this direction.

Kenneth D. Croen, MD, Harrison, N.Y.

Back to top


ADVERTISEMENT

ADVERTISE HERE


Featured
Read story

Confronting bias against obese patients

Medical educators are starting to raise awareness about how weight-related stigma can impair patient-physician communication and the treatment of obesity. Read story


Read story

Goodbye

American Medical News is ceasing publication after 55 years of serving physicians by keeping them informed of their rapidly changing profession. Read story


Read story

Policing medical practice employees after work

Doctors can try to regulate staff actions outside the office, but they must watch what they try to stamp out and how they do it. Read story


Read story

Diabetes prevention: Set on a course for lifestyle change

The YMCA's evidence-based program is helping prediabetic patients eat right, get active and lose weight. Read story


Read story

Medicaid's muddled preventive care picture

The health system reform law promises no-cost coverage of a lengthy list of screenings and other prevention services, but some beneficiaries still might miss out. Read story


Read story

How to get tax breaks for your medical practice

Federal, state and local governments offer doctors incentives because practices are recognized as economic engines. But physicians must know how and where to find them. Read story


Read story

Advance pay ACOs: A down payment on Medicare's future

Accountable care organizations that pay doctors up-front bring practice improvements, but it's unclear yet if program actuaries will see a return on investment. Read story


Read story

Physician liability: Your team, your legal risk

When health care team members drop the ball, it's often doctors who end up in court. How can physicians improve such care and avoid risks? Read story