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Current Practice and Perceptions Regarding Cost Communication in Breast Cancer Reconstruction: Survey Results of the American Society of Plastic Surgeons

  • Reconstructive Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Rising out-of-pocket costs (OOCs) are a major concern for breast cancer survivors. However, information on how plastic surgeons performing breast reconstruction (BR) perceive and communicate cost information is limited.

Methods

An electronic, anonymous survey eliciting plastic surgeons’ attitudes and behaviors regarding BR cost communication was distributed to active American Society of Plastic Surgery members. Questions were derived from previously published studies and entailed a 5-point Likert scale. Cost communication was identified based on dichotomized responses to the prompt, “I discuss the costs of breast reconstruction with my patients,” and analyzed for associated factors.

Results

Of the 5112 surgeons surveyed, 396 plastic surgeons responded (7.21%). Most of the surgeons reported having a sense of a patient’s financial well-being (65%) and an awareness of treatment costs (66.9%). Most felt a responsibility to consider the impact of BR costs (69%). Although most of the surgeons expressed that they were comfortable having OOC discussions (58.9%), only a minority reported doing so routinely (24.2%). The fewest respondents (8.6%) cited OOC as an important variable for BR decision-making. Lack of supportive tools was the most cited barrier to having cost communication with patients (64.8%). Cost communication was identified in a minority (20.2%) of surgeon–patient encounters and had no significant relationship to surgeon demographics or practice setting.

Conclusions

Plastic surgeons rarely discuss costs of BR with patients despite having a high awareness of the topic and feeling comfortable with it. Prevailing attitudes about the importance of OOC and the lack of administrative support or cost information are likely the drivers of this mismatch and warrant further study.

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Acknowledgment

This research was supported by funds from the University Cancer Foundation via the Sister Institution Network Fund (SINF) at the University of Texas MD Anderson Cancer Center.

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Authors and Affiliations

  1. Plastic and Reconstructive Surgeons, Renton, WA, USA

    Chad M. Bailey MD

  2. Department of Plastic and Reconstructive Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Jesse Selber MD, MPH, Jun Liu PhD & Anaeze C. Offodile II MD, MPH

  3. Department of Plastic Surgery, The Ohio State University, Columbus, OH, USA

    Clara N. Lee MD, MPP

  4. Department of Health Services Research, University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Anaeze C. Offodile II MD, MPH

  5. Baker Institute for Public Policy, Rice University, Houston, TX, USA

    Anaeze C. Offodile II MD, MPH

Authors
  1. Chad M. Bailey MD
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  2. Jesse Selber MD, MPH
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  3. Jun Liu PhD
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  4. Clara N. Lee MD, MPP
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  5. Anaeze C. Offodile II MD, MPH
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Corresponding author

Correspondence to Anaeze C. Offodile II MD, MPH.

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Disclosure

The senior author (A.C.O.) has received research funding from Blue Cross Blue Shield Affordability Cures Consortium unrelated to the submitted work and is an advisory board member of the Patient Advocacy Foundation. The remaining authors have no conflicts of interest.

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Bailey, C.M., Selber, J., Liu, J. et al. Current Practice and Perceptions Regarding Cost Communication in Breast Cancer Reconstruction: Survey Results of the American Society of Plastic Surgeons. Ann Surg Oncol 28, 376–385 (2021). https://doi.org/10.1245/s10434-020-08750-w

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  • DOI: https://doi.org/10.1245/s10434-020-08750-w

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