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High medical costs lowers patient trust with their provider.

Posted Jan 09 2009 4:08am
A new study from the Journal of General Internal Medicine reports that the high cost of medical care that patients have to pay for is likely to significantly weaken the level of trust they [the patient] have with their physician. The costs associated with healthcare have been steadily climbing. Healthcare consumes a significant portion of the gross domestic product in the U.S., and the high costs with obtaining care are being passed on to patients in the form of higher out of pocket expenses. Those with private health insurance according to the study have been especially hit hard with higher out of pocket expenses.

The study examines the association between out of pocket medical expenses and patients trust in their physician. Assessments of the quality of care patients received were also looked at. Patients with elevated medical costs were noted to more likely “view their medical encounters in terms of financial transactions and medical providers as economic actors”.

The study included over 32,000 adult patients. Specific elements that the study evaluated were a patient’s overall trust in their provider, confidence in being referred to a specialist, and the belief that the physician uses more services than necessary. Other quality elements that were looked at included thoroughness of exam, ability to listen, and ability to explain.

The study concluded that higher financial burdens that patients had from seeing their physician actually lowered the level of trust that the patient had with their provider, and the perceived level of quality of care that was received.

This type of perception by patients could be disastrous to the way in which the U.S. delivers healthcare. If patients see physicians as nothing more than greedy “economic actors” trying to make up for their own losses from poor insurance reimbursements by milking a patient dry from excessive diagnostic testing and office visits, than several aspects of providing care for patients will suffer. Compliance rates with treatment regimes will decrease. Patients will be less inclined to seek care when they should from their provider, and many patients with chronic medical conditions will likely not be in a state of control with their illness. Clearly this perception which is already a reality if allowed to broaden will cause wide spread skepticism with respect to healthcare as a whole.

Undoubtedly healthcare providers and organizations must take the time to explain treatment options and consequences with patients. Furthermore, the full disclosure of practice and the widest use of provider and organizational transparency must be undertaken to ensure and protect the trust that patients have with their providers. While healthcare grapples with the burdens of reform, providers and healthcare organizations must not lose focus on patient needs, desires, and concerns.
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