The Impact of Cost Conversations on the Patient-Physician Relationship

ABSTRACT

Previous research has suggested that fear of harm to the patient–physician relationship is an important barrier to conversations about cost of care. However, few experimental studies have investigated the effects of cost of care conversations on the patient–physician relationship, particularly from the patient’s perspective. In the current research, we take an experimental approach to investigate patients’ attitudes and preferences for a hypothetical physician who discusses cost versus one who does not. Across three studies, using data from both the general population and cancer patients, we find that people prefer a hypothetical physician who discusses cost over one who does not (Pilot Study, Studies 1 and 2). In addition, we find that people use cost information to inform their hypothetical treatment decisions without changing their attitudes toward the physician who includes this information (Study 1). Finally, we examine how and when cost information compares to more traditional medical information (e.g., side effects; Study 2). We discuss the implications of this research for cost communications and the patient–physician relationship, highlighting that cost conversations may not be as harmful as previously thought.

Disclosure of potential conflicts of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Notes

^1. Please note that we repeated the analyses with insurance status included as a covariate and all results remained the same.

^2. Please note, as in the previous study, we repeated the analyses with insurance status as a covariate and results remained the same.

^3. The scenario is available from the corresponding author.