A headline in the new Business Week asks “Smarter Patients, Cheaper Care?”
The article suggests the answer is yes:
[T]here’s a growing effort, led by physicians, health insurers, and even state legislatures, to make sure patients truly understand the medical evidence about angioplasty and other treatments and procedures. Once informed, the patients are encouraged to make their own choices. This idea goes by the somewhat clunky name of shared, or informed, decision-making. Instead of being routinely whisked in for a prostate screening PSA test, for instance, men would first be told that major studies have failed to show the test saves lives. What’s more, the test increases the chances a patient will undergo surgery or treatments that cause incontinence, impotence, and other problems. “The fact that PSA screening is more likely to cause mischief than save a life is not intuitive to patients or even physicians,” says Dr. Paul J. Wallace, medical director for health and productivity management programs at health-care provider Kaiser Permanente, which is testing this approach.
Studies show this process, using comprehensive videos and other materials prepared by groups such as the nonprofit Foundation for Informed Medical Decision Making (FIMDM), leads patients to choose conservative options more often. It reduces rates of angioplasty or prostate surgery, for instance, by 15% to 30%. Put into widespread use, the approach has the potential to trim hundreds of billions of dollars from the nation’s $2.4 trillion health-care bill.
There’s another way to encourage a patient to learn more about the costs and benefits of particular medical procedures. Make him care about the costs, an idea Joe Coletti has explored.
