Interesting:

What Doctors Don’t Know about Health Costs

Various parts of this:

1. Teach it in Medical School. Medical students are bombarded with an onslaught of medical coursework to master in a short period of time. A good doctor must learn to be clinically competent, articulate, and compassionate; but are they ever taught to be cost effective? This aspect of medical care is so low on the priority list of learning that it simply does not get taught in a meaningful way in medical education.

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4. Accept Reality. Healthcare is not free so we need to seriously consider how much money a life is worth. Every life is “priceless” in its own way, but do you want to spend hundreds of thousands of dollars on the last days of each life in the intensive care unit, knowing the outcome will be death? This should be a very public discussion, but we can’t seem to do it without invoking “death panels” and “pulling the plug on granny”.

The same must be discussed in screening guidelines. The recent USPTF recommendation to restrict mammogram screenings to women greater than 50 years old was met with a public uproar. However, these guidelines are the same as those used in Canada, where women are not dying any sooner from breast cancer than Americans.

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I am often struck by the statement that patients really believe that “their doctor knows best.” In the realm of cost control, I really think that is a big assumption on the part of the patient.