Last September, we wrote here about the inaugural "story contest" held by Costs of Care, a Boston non-profit. It sought hair-raising and heartbreaking tales of health care costs to help "illustrate the importance of cost-awareness in medical decision-making." The stories came rolling in, well over 100 of them, from patients and medical staffers alike, describing horrifying bills and stymied efforts to determine prices. Here's a recap of the results, including the two truly disturbing prize-winners.
Now the contest is back — deadline for stories is Nov. 15 — but with a few tweaks. (Details are here.) There are four $1,000 prizes instead of just two. Different, though similarly prominent, judges. And a somewhat more upbeat focus on positive stories of savings in addition to the negative focus on profligate spending. I asked Dr. Neel Shah, Costs of Care's founder, for an update.
The goal of our first annual essay contest was to collect stories from patients and care providers across the nation that illustrate the importance of cost-awareness in medicine, and then make these stories part of the public discourse by widely sharing them.
From the tremendous response we got to these stories, we demonstrated that there is a clear need to make healthcare costs more transparent. The stories showed how transparency helps patients financially plan for their care and helps doctors keep medical bills affordable.
However we also learned that knowing what tests and treatments cost is only the first step.
Then you have to know what to do with that information, and using cost information at the bedside can be both ethically and pragmatically challenging.
As a result, for our second contest we are not only asking for stories about unexpected medical bills or difficulty figuring out medical costs, but also asking for postive stories about ways doctors and patients have figured out to save money while still delivering high value care.
During the first year we also placed a lot of emphasis on how to frame cost conversations within the doctor-patient relationship. Through this process we realized the importance of firmly establishing resource stewardship as a professional ethic in medicine.
Surveys of the medical profession from Bain and others indicate that as many as 80% of physicians believe that bringing healthcare costs under control is part of their responsibility. The Physician Charter states that avoiding unnecessary costs and providing cost-effective care is part of our obligation.
However, because cost-consideration is currently not taught in medical school, these obligations are not translating into medical practice. Costs of Care recently received a major grant from one of the national medical governing bodies to create the first ever web-based tool that help teach physicians how to ethically and pragmatically consider costs during their routine decision-making.
Neel says he'll let us know when he can make details of the grant public. Meanwhile, if you do submit a story to the contest, we'd love to see it, too, and so would the burgeoning cost-oriented community at Healthcare Savvy, curated by WBUR's own Martha Bebinger, here.
This program aired on September 6, 2011. The audio for this program is not available.