When I was a child, I was scared of going to the doctor. I was afraid Dr. Dailey would give me a shot and it would be painful. A visit to the doctor is still often painful, but in a different way. One thing that bothers me about going to the doctor is not knowing what to expect in terms of the bill. I have Obamacare, which hardly counts as health insurance. My deductible is something like $9,000. Even though I am getting a negotiated discount I am still at the mercy of physicians who are employed by a hospital. Will they insist on new bloodwork billed at hospital outpatient rates? Will they try to slip in a facilities fee? Will they follow the hospital’s revenue maximizing prerogatives or will they work with me like physicians have always done so in years past? If this all sounds like I am being paranoid just think back several years when surprise medical bills were more common. About 10 years ago there was even an article in The New York Times about the patient who got hit with a $117,000 surprise medical bill from an out-of-network assistant surgeon he had never met. At the time Medicare’s fee schedule would have paid $800 for the same service.
A recent survey found that I am not the only one who worries about encounters with the health care system. Two-thirds of the survey respondents were concerned about care affordability, compared to 45% last year. According to the survey nearly 40% of respondents aged 26 to 54 have not gone to a doctor in the past five years.
Four in 10 Americans (41%) say they put off going to the doctor.A survey of 2,000 nationally representative Americans found that being potentially unable to afford their care (52%) was a top reason.Other reasons for avoiding their doctor included anxiety about potential procedures or tests (40%), fear of receiving bad news or a serious diagnosis (39%) and exhaustion from parenting or caretaking (39%).
Anxiety over going to the doctor has risen 9 percentage points, equal to nearly half of Americans. Although 80% claim they trust their health care provider, nearly half of Americans feel they lack sufficient information to adequately prepare for a physician visit. Roughly half of Americans would like to learn more about their condition prior to the visit in addition to having their physician educate them during the visit.
I have talked to other people who said they feel too rushed in the exam room and don’t feel they have enough time to ask all their questions. A survey from years ago claimed that patients forget to ask some of their questions and when they think to ask their questions, they retain less than half what they were told.
Oddly enough, Americans have never had more tools to learn about their health conditions. Patients have embraced the Internet to learn about medicine. Paradoxically, now that patients have more resources to educate themselves, they probably want more information from their doctors. At its core, the doctor-patient relationship is an information exchange. However, these exchanges are being shortchanged by time constraints.
What would make patients feel more empowered to talk with their HCP about their health? Receiving education about their health during their appointment (55%), knowing that there’s treatment for their symptoms/condition (53%) and receiving education about their health before their visit (43%).People’s healthcare providers are their top source of health information (57%), followed by Google or another search engine (43%) and social media (31%).
Americans’ anxiety about seeing their physicians is partly related to our health care system’s utter indifference to transparency caused by a lack of competition. The shortage of primary care physicians certainly doesn’t help. When your primary care physician’s schedule is fully booked you have few other options if you are not getting the information you need to manage your health. I have found that being clear and honest about being price sensitive helps. I have also found that thinking through your questions ahead of time and not being unnecessarily chatty with your doctor about things that don’t further your mission.