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Shared decision-making may lead to higher medical costs

  • Sep-25-2013
  • Richard Reich

Physicians are sometimes criticized for not always involving patients and their families in making medical decisions. As a result, there has been a growing push to incorporate shared decision-making (SDM) into the treatment process. SDM is encouraged because informal and anecdotal evidence suggests that engaged patients are more informed and more likely to weigh the pros and cons of any treatment decision. In addition, they are usually more satisfied with their medical treatment. 

SDM has also been promoted as a way to prevent over-treatment and reduce costs, but a commentary published in the Journal of the American Medical Association suggests otherwise. 

"The assumption that the doctor is pushing harder than the patient for the most aggressive treatment is misguided," wrote the commentary's co-authors, Dr. Steven Katz and Dr. Sarah Hawley. 

In their report, they cited 14 studies conducted between 1995 and 2009 that tested the benefits of SDM. The authors only found five that suggested that increased patient involvement resulted in cost-effective treatment. Most of the studies had the opposite result, with patients receiving too much treatment and dealing with high out-of-pocket expenses. 

While they wrote that they agreed that patient involvement is an important part of medical treatment, Katz and Hawley emphasized that there should be a balanced doctor-patient relationship. 

"Patients are looking for the doctor to help them make the right decisions," Katz and Hawley wrote. "We have a concern about over-treatment or doing more harm than good, which is something the patient and doctor need to work through."

There is nothing wrong about being actively involved with your health. Being free from illness is important to your family's future. It is important to remember, however, that your family still needs to be protected in the event that you're no longer with them. Consider adding a term life insurance policy into your financial plans. 

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