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Patient-doctor disagreements lead to unnecessary spending, study finds

New research suggests that improving communication between consumers and clinicians is an untapped opportunity to reduce healthcare costs.

Jeff Lagasse, Associate Editor

Doctors and older patients may disagree more often than either of them suspect in regards to whether a particular medical test or medicine is truly necessary, 

Improving communication about that very mismatch of opinions might reduce the use of unneeded scans, screenings, medications and procedures -- and it might cut healthcare costs as well, according to findings from a new poll of Americans over age 50.

[Also: Low-value health services fuel $586 million in wasteful spending, Health Affairs study says]

Only 14 percent of people in that age range believe that more is usually better when it comes to healthcare, according to the new findings from the National Poll on Healthy Aging. But one in four say their health providers often order tests or prescribe drugs they don't think they really need. One in six said it had happened in the last year, but about half of them followed through with the test or filled the prescription anyway.

On the flip side, about 1 in 10 of those polled said their doctor had told them that a test or medication they'd asked for wasn't needed. Most of them said the provider explained why, but 40 percent didn't completely understand the explanation.

In all, 54 percent of those polled said that in general, they believe that health providers often recommend tests, medications or procedures that patients don't really need. This means doctors and other clinicians may have more leeway than they might realize to hold back on recommending services that hold little or no value for certain patients -- or to help patients understand why a service they're asking for probably won't help them.

In the poll, 50 percent of patients who had been told they needed an X-ray, blood test or other test, but weren't sure they needed it, went on to have it anyway. Among those who had received a medication recommendation that they didn't think they needed, 41 percent still filled the prescription.

In short, patients and providers need to communicate better to mitigate a wasteful use of resources, the authors said. To that end, they point to the "Choosing Wisely" website created by medical professional groups as a central source of information about which tests and treatments hold low value for certain patients. It provides specific examples, based on medical research, and gives explanations using language that both patients and providers can understand.

When a provider recommends a medical service but the patient isn't sure it's needed, better communication could increase the use of services that provide the most value, the authors said.

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com

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