Open AccessBarriers to Patient‐physician Communication About Out‐of‐pocket Costs
Author(s) -
Alexander G. Caleb,
Casalino Lawrence P.,
Tseng ChienWen,
McFadden Diane,
Meltzer David O.
Publication year - 2004
Publication title -
journal of general internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.746
H-Index - 180
eISSN - 1525-1497
pISSN - 0884-8734
DOI - 10.1111/j.1525-1497.2004.30249.x
Subject(s) - medicine , recall , family medicine , legitimacy , metropolitan area , health care , variety (cybernetics) , medline , nursing , philosophy , linguistics , pathology , artificial intelligence , politics , political science , computer science , law , economics , economic growth
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.