How can physicians promote patients' financial health?

In addition to honing the skills required to diagnose and treat patients clinically, physicians in medical school should be learning how to provide quality medical care that isn't just effective but affordable to patients. That's the message of a recent editorial by Dr. Steven E. Weinberger, chief executive of the American College of Physicians, published in the Annals of Internal Medicine.

In reality, though, physicians usually enter practice with no idea how the prescriptions they write and the tests they order affect patients' wallets, he wrote. Moreover, the culture of residency tends to promote ordering more tests to cover one's bases rather than taking a critical look at why a test is ordered and what will be done with the information.

Early efforts at the residency level so far have not resulted in a reduced cost of care ordered by residents, notes the Los Angeles Times. According to Weinberger, that's merely a signal to keep trying.

"Now that cost control in health care has reached a crisis level, it is essential that we ... change the culture of the training environment with regard to health care costs. Residents ... must be thoughtful in ordering diagnostic tests, avoiding the overuse and misuse of imaging studies and laboratory tests that have become rampant in health care," he wrote. "They must avoid duplication of studies and must be conscious of opportunities to prevent avoidable hospitalizations or readmissions. In short, they must become part of the solution to control health care costs."

As for practicing physicians who already are entrenched in the current culture of avoiding money discussions with patients, they'll have to learn to change their ways on the job.

But with patient encounters already happening at warp speed and nearly a quarter of some doctors' work hours spent keeping up with administrative hassles, this is no small task. Not only do physicians not have the time to initiate cost conversations, but most of them don't have the tools.

As a consumer doing my best to make sound medical-financial decisions for my family and myself, I'm encouraged to see that this may be slowly changing in my home state of Massachusetts. As we reported last month, a new price list given to doctors affiliated with Beth Israel proved eye-popping, to say the least. Within days of becoming armed with a list of prices associated with 56 common medical procedures, costs entered these doctors' consciousness, at least on some level. One physician even said he'd start factoring colleagues' expensive test-ordering habits into his future referral decisions. While it may take more than a list to result in significant change, giving physicians access to the information is certainly a positive first step.

But with medical debt pushing an unprecedented number of patients into personal bankruptcy, a multitude of solutions are needed. A couple of recent contests aim to solve this problem, including an essay contest held by nonprofit Costs of Care, in which patients and doctors are encouraged to send in submissions that illustrate routine opportunities for physicians to curb unnecessary spending and improve care, Neel Shah, executive director of the group, told the Los Angeles Times.

FierceHealthcare also is hosting a contest of its own. We're welcoming any and all ideas you have for improving healthcare delivery, quality, and patient outcomes. To enter, just follow @FierceHealth on Twitter and submit your healthcare-improvement idea. The winner will be featured in an upcoming issue of FierceHealthcare and receive a $25 gift card. Learn more about how to enter here, and good luck! - Deb