Monday, September 14, 2015

Medical Schools Teach Students To Talk With Patients About Care Costs : Shots - Health News : NPR

In 1969 while I was completing an internship in general medicine I remember examining very ill patients who were starting on the never-ending conveyor belt of testing, and treatments, study after study, and some treatments that were very painful in the face of a poor prognosis or outcome. The Intensive Care Unit was a point often of diminishing returns of investment of time and money.

During the 1960s not much was made of cost, either by attending physicians, doctors in training, or hospital administrators.  There were   no HMOs, or managed care. Medicare had just begun in 1963 and had not yet fueled medical inflation.

Although not a high priority issue at the time I would think and ask question, "what are we doing to this patient" The 'primum non-nocere' theme did not seem to apply to financial or family  concerns.

After a life-long career in medicine I now know that not only does the  patient have the disease (especially if chronic, such as diabetes, heart disease, cancer or a multitude of others) the family also 'suffers' directly or indirectly.  The patient may become disabled, lose employment and suffer severe financial setbacks that will involve an entire nuclear family.

The effect of a hospitalization ending in short term or long term disability will impact financial capability to purchase interim COBRA coverage, or even insurance in the long term.

Medical curriculum has changed. Courses in health information technology, multiculturalism, prevention, nutrition have become standard faire in additon to the overwhelming facts in science and medicine. Now add the economics of medicine, and not just as a 'theorectical' macroeconomic theory, but also as a microeconomist talking face to face with a patient and/or family member.

The depth of knowledge which a good physician should be aware, run the gamut from medi-caid, medicare, and the affordable care act.

Medical Schools Teach Students To Talk With Patients About Care Costs : Shots - Health News : NPR
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