Yesterday we talked about the physician rating sites that are popping up on the Internet. The popularity of these sites suggests that patients are not willing to blindly follow their doctors without question. Instead, they are posting criticisms of the care they receive online for the world to see. We are wondering what impact this type of patient behavior will have on overall health outcomes and on the cost of our healthcare system.
At the same time, a survey conducted by the Kaiser Family Foundation, NPR and the Harvard School of Public Health suggests that maybe doctors shouldn’t be so concerned about losing the trust of their patients- especially when it comes to making discretionary treatment decisions.
Survey participants were asked whether they thought it was a “major problem,” “minor problem,” or “not a problem,” that too many patients get tests and treatments that they don’t need.
- 49% of respondents said it was a major problem; and
- 39% said it was a minor problem.
But, when it came to their personal treatment by doctors over the last two years:
- 82% of respondents said that they hadn’t received any unnecessary medical test or treatment; and
- 87% said that their doctor had not recommended a more expensive test when a cheaper alternative would have worked just as well.
So folks realize that it is a major problem that doctors tend to over treat patients and to overuse newer technologies.
But they don’t believe that their personal doctor is at fault.
In other words, patients trust their doctors to do what is best for them, and for society at-large.
These findings have important implications when it comes to healthcare reform.
President Obama and Congress should remember that patients trust their physicians when recommending care.
As a result, efforts to reduce spending might focus on providing doctors with cost-effectiveness research on the comparable efficacy of differently-priced procedures and medications so that doctors can alter their practice behavior by taking cost into account.
The final question to ask here is,
“Which patient behavior described in these two posts will lead to better outcomes- both in terms of patient health and overall financial well-being?”
In other words, is it better for folks to fulfill the patient role described by Parsons and accept their doctor’s treatment recommendations without question? Or should patients assume a more involved, critical role when receiving treatment?
As the NPR poll shows, few patients question whether or not their doctors are administering the most efficient care possible. As a result- more tests and procedures are prescribed, which raises the cost of our healthcare system.
And patients should speak up, ask questions and do their own research about the care that they receive.
- The more a person knows about his or her condition, the better equipped he or she is to follow-through with their treatments and stay on track while managing a chronic condition.
- In the worst case scenario, patients may be able to perceive that the doctor has made a major or minor mistake that must be corrected.
At the same time, we don’t advocate that patients criticize their doctors without warrant on the Internet, or that they file excessive medical malpractice suits that lack sufficient merit.
While Parsons’ definition seems a little outdated, there is still something to be said for the special trust and bond that exists between a patient and her doctor.
We’ll be interested to see how this trust issue affects the implementation of federal healthcare reform initiatives in the future.