Blog | Wednesday, September 21, 2011

Price lists needed for medical tests


I am smacking myself on the forehead and saying, "Why didn't I think of this?" Richard Parker, MD, Medical Director at Beth Israel Deaconess Medical Center, has sent out a list to his physician colleagues of 56 common medical tests and procedures. What is revolutionary is that there are prices next to each item. You non physicians may be surprised to know that we doctors have no idea what the tests or drugs we order actually cost. Unless we get billed as a patient, we are as clueless as you are.

As I wrote before, the ostrich excuse just won't fly any more. We all need to be aware of the cost of care and have skin in the game. Some will argue that price can't be the only driver. I've heard physicians say you can't compare one price to another because "quality" costs more. I say prove it. If you have a quality product or are a higher quality physician, show us the results. What are your outcomes? Is your customer service better? Is it worth the higher cost you charge? Let's be transparent and let the patient determine what something is worth.

Separate from physician fees, however, is the variability and wide ranges in costs of similar tests. I hear from my patients who have high deductibles and pay first dollar coverage for their health care. I frequently order a screening vitamin D test and found out the patient was billed as much as $200 for one test. A colonoscopy can cost as little as $1,100 and as much as $2,600. That is a huge price variance. What about ultrasounds and MRI scans? The variation in price is astounding.

Dr. Parker says he wants doctors to think about the cost of the things that they are doing. "We're not saying don't give patients what they need," says Parker. "We'll fight hard to get them what they need, but please don't give them what they don't need. We just can't afford that anymore."

I have been calling for transparency in pricing for a long time. Patients and physicians need to know what things really cost. Maybe I'll try what Dr. Parker did for my area ... if I can find out the prices, that is.

This post originally appeared at Everything Health. Toni Brayer, FACP, is an ACP Internist editorial board member who blogs at EverythingHealth, designed to address the rapid changes in science, medicine, health and healing in the 21st Century.