Involved Patients Pay More, New Study

Elaine Radford

Involved patients pay more for medical care, sometimes a lot more. According to a study published Monday in JAMA Internal Medicine, a patient who insists on sharing medical decisions with his or her doctor will spend more money and more time in the hospital.

Researchers from the University of Chicago Medicine wanted to investigate the often-repeated advice that patients need to be more involved in making medical decisions to control costs and receive better results. Their counter-intuitive findings were shocking:

"There are about 35 million hospitalizations each year in the United States. If 30 percent of those patients chose to share decision making rather than delegate that role to their doctors, it would mean $8.7 billion of additional costs per year."

The long-term study examined almost 22,000 patients admitted between July 2003 and August 2011, so it probably wasn't just a mathematical quirk caused by a small statistical sampling size.

And the costs weren't trivial. The involved patients stayed in the hospital an average of about 5 percent longer, causing them to rack up an average $856 extra in charges.

The UC Medicine researchers added that they weren't trying to discourage people from being involved in their own care. But the takeaway lesson seemed to be that if you do question the doctor, you may get better care but you'll also pay more.

One reason could be that if a patient asks too many questions and seems overly anxious, doctors may feel obligated to protect themselves against potential lawsuit lottery players by ordering extra tests or treatments. Doctors probably don't feel as worried about trusting patients who are clearly relying on the medical team to make the best decisions.

Another reason for the higher costs could be that it always takes more time for a committee to come to a decision. The back-and-forth between involved patients and their medical teams comes with a cost in time -- and we all know that time costs money.

Ironically, on Tuesday -- the very next day -- JAMA Internal Medicine released a second study which called for patients to become more involved in medical decisions with their doctors.

A study by Dr. Floyd J. Fowler and his colleagues at the Informed Medical Decisions Foundation in Boston, MA showed that patients were mostly left out of the decision-making process.

No offense to Dr. Fowler, who is undoubtedly well-intentioned, but many Americans can't afford their medical expenses as it is. Doctors go to school a long time. I don't know about the rest of you, but I don't see much value in trying to tell the doctor how to do his or her job -- especially if I'm going to have to pony up almost another $1,000 for the privilege.

What's your gut reaction to the study revealing that involved patients pay more for their medical care?

[doctor involved with patient photo by Kzenon via Shutterstock]