Healthcare News & Insights

‘I can’t afford treatment’: Awkward conversation becomes more common


Physicians and other health care providers are being forced to rethink how they talk about patient costs when suggesting treatments.

It’s no secret patients are getting squeezed, and increasing health care costs are only part of the problem: More people have lost insurance following lay-offs. And many of those who still have insurance are finding that their coverage is significantly reduced and/or the portion of the bill they’re expected to pay has increased.

According to the American Medical Association, the evidence shows that most doctors are aware of the issue, but frank discussions of expenses just aren’t happening during most patient visits.

No doubt part of the problem is that the conversation is awkward for everyone involved. But once the issue is addressed, physicians report that most patients are relieved.

More importantly, having a realistic idea of the patient’s resources lets a health care provider provide the best possible treatment plan. After all, the most effective drug in the world won’t do patients any good if they can’t afford to get the prescriptions filled.

Dollars and sense

The AMA offered some advice and even suggested language for doctors and other clinicians to use when discussing options and costs with patients:

  • Look for cues such as body language that indicate costs may be of particular concern to a patient. For example, if a patient looks away, shrugs or crosses her arms when you mention a specialist visit or expensive treatment, that’s a red flag that cost is an issue.
  • Don’t assign blame. Denouncing a less-than-stellar insurance plan doesn’t solve anything and may make the patient feel even less in control of the situation.
  • Follow up when prescriptions are unfilled or other care, like physical therapy, is ignored. It could be a signal the co-pays are too expensive for the patient.
  • Stay up to date on the rough costs of treatments. You can’t — and patients don’t expect you to — know the precise cost of every drug or treatment. But being able to put a rough price tag on the cost of a suggested treatment gives the patient more information on which to make a decision — and they’ll be less likely to assume a particular treatment is out of their reach.
  • Remember anyone can have trouble paying health costs. Even some people with insurance or “good” jobs are finding themselves struggling right now. Just because finances were never a problem before doesn’t mean a seemingly well-off patient isn’t pinching pennies now.

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  1. Don Stumpp says:

    I have a good job and an HDHP with $5000 deductible. I have high cholesterol and after trying diet changes and a generic statin which evidently didnt help, my doctor now has me taking Crestor. The cost is over $100/mo. That’s $3 a pill.

    I think I would rather take the $100 and buy life insurance. I’m not really ready to cash it in, but it does make me wonder.