The “Bad” word in Medicine
By: David Wong, MD
When I was a third year medical student, on my Internal Medicine rotation, I vividly remember asking on rounds, “why do we order labs every day when nothing has clinically changed about the patient? Isn’t that costing a lot of money?” My attending at that time responded, “it’s our job to think of the patient first and money should not be in your decision making.” In my head I thought, “if we’re not watching what’s spent, then who is? And who’s supposed to?” Of course, not wanting to flunk my rotation, I kept my mouth shut.
That was 14 years ago now – and what’s really interesting is that the bad word of medicine “money” has finally come full circle. Everyone agrees that the current paradigm can’t continue – it’s simply unsustainable. The overwhelming healthcare costs in America are crippling our country and threatens to destroy it. Everyone is pointing fingers trying to find someone to blame and when I reflect on it, I have to say, that we as physicians, have to take some accountability.
To some degree, the system and culture is flawed – that for too long, talk of the finance of healthcare was considered taboo. In fact, for that reason we avoided the topic when it actually should have been part of our education. I think it would be very easy to argue that to a large degree part of why our country is in such financial straits is that a very large portion of our population is financially illiterate. Sadly, physicians are probably not much better. I had this exact debate (in marriage, it’s called an argument) with my wife who’s an Ob/Gyn, recently. Her response was that most people go into medicine because they don’t like finance and they just want to be able to practice medicine. That’s fair.
But here’s the reality – we’re among the top 2% most educated part of the population. It’s incumbent upon us to have some rudimentary understanding of finances – especially when it comes to how it relates to healthcare. As painful as biochemistry and histology were, we learned them. 90% of us don’t use them ever again. I can nearly guarantee you that if healthcare finance were taught in medical school, most of us would use that knowledge at least monthly if not more.
At the very least, it’s our responsibility to have that knowledge so when healthcare administrators have that dialogue with us, we’re at least communicating in the same language. We, as physicians, are bound to advocate for our patients. I would propose that without the knowledge of healthcare finance, we are doing a disservice to our patients.
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About the Author:
Dr. David Wong is a practicing Board Certified Emergency Medicine Physician. He is also CEO and Co-Founder of SnapHealth, a market-based web solution to healthcare – empowering consumers and providers with real-time pricing information to make more cost-effective healthcare decisions.
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