Barriers to patient-physician communication about out-of-pocket costs
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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.
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- Barriers to patient-physician communication about out-of-pocket costs
Journal of General Internal Medicine
Volume 19, Issue 8 , pp 856-860
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- patient-physician communication
- out-of-pocket costs
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- Author Affiliations
- 1. RWJ Clinical Scholars Program, The University of Chicago, 5841 S. Maryland, MC 2007, 60637, Chicago, IL
- 2. MacLean Center for Clinical Medical Ethics, University of Chicago, Chicago, Ill
- 3. Department of Health Studies, University of Chicago, Chicago, Ill
- 4. Pacific Health Research Institute, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii
- 5. Department of Family Practice and Community Health, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii
- 6. Biological Sciences Collegiate Division, University of Chicago, Chicago, Ill
- 7. Harris School of Public Policy, University of Chicago, Chicago, Ill