Do patient demands drive up health care costs?

According to recent data from the Pew Internet & American Life Project, upwards of 60 percent of patients first consult the internet for their health issues.

This is leading to more educated patients, taking an increasing role in their own health care. And that’s a good thing. I’d rather be seeing patients who are interested in staying healthy and conscientious about their conditions.

But it’s unfortunate that the incentives within our system don’t encourage these so-called participatory patients.

Having a vibrant discussion with patients, answering their questions, debunking false information found on the web, all takes time. Which is sorely lacking in today’s primary care practice environment. And in this piece from NPR, this time pressure leads doctors to acquiesce to patient demands, more often than not.

Family physician Teresa Moore was interviewed for the piece, and estimates that “30 percent of the costs in her practice are driven by patient requests.” This is an indictment of the system, since doctors like her encourage participatory patients. But the reality is that the crushing burden of paperwork and pre-authorizations are wearing, leading doctors, like her, to “complete paperwork [late into the night] so that she is able to spend enough time with her patients during the day — enough time to explain why this test is probably not necessary, why that pill wouldn’t be a good idea. And her children, she says, pay the price.”

In the end, rather than having a conversation with patients explaining the pros and cons of excessive tests and medications, for instance, the system incentivizes doctors, more often than not, to give patients what they want.

And that drives up health spending.

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