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Author Topic: NYTimes article: Cost of treatment influencing doctors  (Read 955 times)

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Offline pittman

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  • Posts: 217
NYTimes article: Cost of treatment influencing doctors
« on: April 19, 2014, 10:32:01 AM »
http://www.nytimes.com/2014/04/18/business/treatment-cost-could-influence-doctors-advice.html

I see a lot of questions and discussions come up on here about cost of treatment, affordability, and the selection of particular drugs.

I  thought the article was interesting as it touches upon influencing medical decisions with cost impacts. I think that is ok in concept, though it can become uncomfortable if you think you are not getting the best of the best, rather than just "good enough".

They don't mention HIV specifically, but HEP-C is called out over its newest treatments.

I do know that my doctor was shocked at what I actually had to pay out of pocket for my own care, and tried to keep that in mind. I appreciated that he would actually engage on the topic and try to discuss medical options in addition to just looking to only hand off to a social worker to look for programs. 

I am guessing his regular volunteer work in Africa might make him more considerate of financial impacts as well.

Offline mecch

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  • red pill? or blue pill?
Re: NYTimes article: Cost of treatment influencing doctors
« Reply #1 on: April 19, 2014, 11:06:16 AM »
Doctors are supposed to know the available treatments, their various efficacies, and the financial contexts for each. 

In the US and in Switzerland I do discuss costs of treatment.  When my elderly relatives have been in terminal illness stage, cost of treatment was always something discussed.  I don't see anything new here. 

Of course its good if more doctors learn more about costs and also if more patients are willing to frankly discuss affordability.  But, as I said, I had such conversations back in the 80's (when I had the fattest most generous health coverage I will ever have, but still sometimes couldn't figure out how to pay for recommended treatments. Or conversely when i was sometimes surprised to find that I was covered for things I never imagined I could afford.) 
« Last Edit: April 19, 2014, 11:10:38 AM by mecch »
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline Theyer

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Re: NYTimes article: Cost of treatment influencing doctors
« Reply #2 on: April 19, 2014, 12:13:27 PM »
Cost, in any system has to be a feature off health decisions .
"If we can find the money to kill people, we can find the money to help people ."  Tony Benn

Offline GSOgymrat

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  • HIV+ since 1993. INTJ
Re: NYTimes article: Cost of treatment influencing doctors
« Reply #3 on: April 19, 2014, 12:19:17 PM »
I deal with this all the time. Some psychiatrists in the community prescribe mental health medications that patients cannot afford, which is the same as prescribing nothing. These psychiatrists will also tell patients they can get samples of medications from the county crisis center, which frustrates the staff because more often than not they don't have samples and even if they did that is maybe 2 weeks of treatment. Most psychiatrists know better and will use the Walmart $4 prescription list for patients who don't have financial resources. Even then I have driven patients to Walmart on my lunch break to pay for their $4 medications because they just don't have the money. I understand that doctors want to only focus on efficacy but that is not practical given the current state of healthcare.

Offline Theyer

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  • Current ambition. Walk the Dog .
Re: NYTimes article: Cost of treatment influencing doctors
« Reply #4 on: April 20, 2014, 02:37:49 PM »
I deal with this all the time. Some psychiatrists in the community prescribe mental health medications that patients cannot afford, which is the same as prescribing nothing. These psychiatrists will also tell patients they can get samples of medications from the county crisis center, which frustrates the staff because more often than not they don't have samples and even if they did that is maybe 2 weeks of treatment. Most psychiatrists know better and will use the Walmart $4 prescription list for patients who don't have financial resources. Even then I have driven patients to Walmart on my lunch break to pay for their $4 medications because they just don't have the money. I understand that doctors want to only focus on efficacy but that is not practical given the current state of healthcare.

Its beyond not practical its a cruel Joke to perscribe a drug in the full knowledge that the person can not afford it or at best has a shot at an unstable supply .  I would counter any that's not my responsibility very quickly , the Dr and Patient consult with in societies boundaries not bubbles .
"If we can find the money to kill people, we can find the money to help people ."  Tony Benn

Offline OneTampa

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Re: NYTimes article: Cost of treatment influencing doctors
« Reply #5 on: April 20, 2014, 04:35:54 PM »
I am pleased that my Primary Care Physician of 25 years (now out of network) and HIV Specialist of 15 years (in network) consider treatment costs that are also effective for my health situation. I get as many labs and procedures done in network as possible through my health care plan along with prescriptions.  My Primary Care Physician allows me to pay in manageable installments as well.
« Last Edit: April 20, 2014, 04:41:05 PM by OneTampa »
"He is my oldest child. The shy and retiring one over there with the Haitian headdress serving pescaíto frito."

Offline Jeff G

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  • How am I doing Beren ?
Re: NYTimes article: Cost of treatment influencing doctors
« Reply #6 on: April 20, 2014, 08:15:36 PM »
My GP doctor uses a PDA system that links to my insurance company that tells him what prescriptions will be covered while he is in the room with me, that way there is no nasty we have to start all over again pharmacy moments when you realize you are going to have to call the doctor and get an authorization or another script .   

 


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