Future Doctors Take a Crash Course in Economics

After a busy weekend moving and an even busier week at work preparing to present five sessions at our company’s annual conference, we are a bit more settled now.  On top of that, internet has been restored to the household!  That makes posting these blogs much easier.  Thanks everyone for your patience 🙂

nprNow that my husband and I are moved into our new home, I have a sizable commute to work.  I actually don’t mind the commutes too much.  The pre-work commute gives me time to organize my thoughts and get my tasks for the day prioritized before I even sit down in my cube, and the post-work commute lets me wind down before coming home to the seemingly constant unpacking of boxes.  But there is another advantage to these commutes: they give me a great opportunity to listen to NPR’s Morning Edition and All Things Considered, two of the best (and really the only two remaining) news programs available.

While listening to All Things Considered last week, I heard a fascinating story from journalist Rebecca Plevin about how some of the larger medical schools (such as UCLA) are now adding discussions about healthcare costs to their medical students curriculum.  The article, which can be found here, profiles some of the different courses and discussions that doctors are beginning to prompt new medical students to think about as they are treating patients.  According to the article, 129 of 140 medical schools that responded to a survey from the Association of American Medical Colleges offered a required course dealing with the costs of healthcare during the 2013-14 school year, and 40% of them also have electives covering the same subject.

With more people getting healthcare plans through programs like the ACA that are high deductible, patients are putting more money on the table for their care before insurance companies start kicking in, and that is causing many of them to ask questions about why expensive medications or tests might be ordered.  The article also cites the ACA itself as a contributing factor to these changes, as healthcare shifts from a fee-for-service model to a fee-for-quality model.  In the article, a pre-med student relates the story of how he was volunteering at a free healthcare clinic when a woman presented with high levels of protein in her urine.  The doctor running the clinic suggested a $400 test to check for cancer, which was ultimately turned down because of the costs.  The med student pointed out that this test, on top of being expensive, would only have “raised more questions than answers”, and that he questioned the decision to order it.

This is another article profiling several different changes to medical school in the last year or so.  I have read about schools beginning to accept more humanities majors, schools adding basic technology training, and making general changes to adapt to the changing needs of modern healthcare.  It seems as though health care is finally beginning to recognize that while traditions are important, they can cause problems when they are your only guiding principle in a modern world.

Healthcare CostsI am heartened to see these changes being made, especially adding the cost discussion into consideration during patient care.  So often, physicians have no idea how much a particular prescription or tests will cost, and as a patient the only way you can advocate for yourself is to have an idea of it yourself.  I have had doctors ask me during appointments how much prescriptions cost when I would as if there was a generic available because previous prescriptions had been expensive. They had no clue that a medication they were prescribing me was running close to $100 in out-of-pocket costs!  I don’t think it’s done maliciously…I honestly see it as the natural result of a broken system in which doctors don’t examine how much things costs, and often prescribe medications based on sales associates promises or amazing results published in a fancy journal and don’t bother to ask how much it will cost and whether there is another option for those of us who cannot afford it.

The first step to fixing any problem, it is often said, is to first acknowledge that there is one.  The rapidly rising costs of healthcare are unsustainable, and they are a big problem.  This may only be one piece of the pie, but by raising awareness of it you can begin to take steps to address it.  And that’s a win for everyone.

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