Friday, January 24, 2014

Cost of Care

We had Chris Moriates come and talk at our grand rounds about cost of care and the need for physicians not to do financial harm in course of caring for our patients. Briefly, he called on the need to be mindful about what we do to patients and think about all our actions.

As I work in our inpatient unit, I have been thinking about what we do in health care and how factor in cost in daily work. Traditionally, costs have been in the domain of health economics and abstruse disciplines that we rarely think of while working with patients. Most patients, however are aware of co-pays, medication prices, ambulance charges and assorted deductibles. Even the ACP ( American College of Physicians) has said in its ethics  manual that equity and cost effectiveness is an important consideration in health care.

These are all meta considerations which can be best done when we consider the whole population even as we treat the individual patient. During bedside rounds, I've been trying to question every investigation we do on our patients by asking why are we doing this test? Is this the best way to get the information we need to care for our patient? Will this test change management? This mindful approach helps us cut down unnecessary testing and is my way of doing "slow medicine" in the hospital. Talk before testing, works for me.