Being an Informed Consumer - Question Everything

Today's topic is a little heavier than I usually do on the blog, but it's something I feel passionately about and don't get the chance to write about often.

Let's talk about being an informed healthcare consumer.

So often, we go to the doctor and we enter this role of patient — vulnerable, inexperienced — where we defer to the opinion of someone more knowledgeable. It can be tough to ask questions. I have had instances where I was made to feel as though I was out of line for asking "why."

My doctor visits are no longer a $20 co-pay. I have to ask questions, if only to know whether I will be able to pay the bill. I have an $11,000 family deductible. My monthly premiums are not insignificant either. Anything not considered preventive care, falls under the deductible, meaning I have to pay it out of pocket.

Given these expenses, I feel I am a consumer as well as a patient. I need to shop for services, determine what provider I like, and question the value I get for my money.

Overuse in healthcare

Too often, doctors order unnecessary tests and scans just to be safe. As patients, we feel we need to be sure that everything is clear, even though a test is likely to provide no added value.

When my dad was undergoing treatment for stroke, he received repeated tests and imaging scans, most often showing nothing. While I won't say they were useless — we learned what was not happening — they didn't always add value to his care. Even more concerning, the various specialists recommending all these tests didn't seem to be speaking to one another at all.

In a recent article for The New Yorker, Atul Gawande wrote "Virtually every family in the country, the research indicates, has been subject to overtesting and overtreatment in one form or another. The costs appear to take thousands of dollars out of the paychecks of every household each year."

Question everything

This problem isn't all on the doctor's shoulders. Sometimes the patient asks for unnecessary treatment. That's where I think we need to consider ourselves consumers as well. Healthcare is essential, but it is also a business. As consumers, we deserve maximum value for our money. We need to ask questions, even for simple office visits.

I took my daughter to the doctor one year because she had symptoms of strep. The PA wasn't positive if it was strep and suggested we go to the lab for a culture. I asked whether the results would change her treatment choice. She said no, and we skipped the lab. That's a simple example, and it probably saved more time than money, but I was already spending $75 for the visit, plus the prescription cost. I didn't find value in knowing the result.

Questions to ask

Bigger problems require bigger conversations with your doctor, but for routine visits, there are a few questions you can ask that may save you time and money:

Photo by Jorgejesus4 via Wikimedia Commons

1. What is the test for? What will the results tell me?
2. What does the test/treatment cost? And what does my insurance cover?
3. What is my diagnosis?
4. Will the result of this test change your treatment recommendation?
5. What are the risks vs. benefits, including cost, of this treatment/test?

In this new era of higher cost-sharing, we are more responsible for our care than ever. Unnecessary care can have much more harmful results than overspending, and I encourage you to read the article linked above.

It's important that we become informed consumers to save ourselves unnecessary heartache and expense.

What questions would you add to this list?