By Donald L. Trump and Michael W. Cropp
We would like to offer a different viewpoint from that of the recent commentary in The Buffalo News that suggested that improving health care and reducing health care spending should not involve “burdening doctors with the pressure of having to weigh costs as they make decisions about patient care.”
Physicians must concern themselves with the costs of care, in keeping with a focus on their patients’ well-being and prospects for improved health. Recent studies show that more than one-third of cancer patients have serious concerns about the cost of their care – concerns that negatively impact their physical well-being, quality of life and satisfaction with their care.
Given this evidence, we must be concerned about the numbers of patients who will leave their physician’s office having agreed to a course of treatment but not follow through because of the costs of that treatment – and who are likely to then be burdened by feelings of inadequacy, anxiety or shame.
We must begin to consider value in health care, weighing the effectiveness or outcome of therapy as well as cost. Many new treatments for cancer and other diseases are expensive and provide statistically improved outcomes that have only marginal clinical value. It will also be important to develop a compensation system that rewards the physician for making the recommendations that serve the best interests of the patient and removes from the physician any economic interest in further diagnostic testing or treatment of the patient.
Academic institutions, such as Roswell Park Cancer Institute, health care providers, health insurers, such as Independent Health, and professional societies are working hard on the thorny problem of providing analyses that inform physicians about the value of available treatments and procedures so that they can best inform and advise their patients.
But these are difficult analyses. Our current metrics for measuring quality of treatment outcome are imperfect, but for the sake of the physical, emotional and financial well-being of our patients, we must develop better analyses to inform our decision-making. And physicians, who will explain those considerations to patients, should be leading these conversations.
If our patients are worried about the cost of their care, how can we, as physicians, not be worried? On a societal level, how can any citizen not be worried about the rapidly escalating costs of medical care?
Donald L. Trump, M.D., is president and CEO of Roswell Park Cancer Institute. Michael W. Cropp, M.D., M.B.A., is president and CEO of Independent Health.