As physicians, we have fundamentally failed to clearly communicate to patients what we do, what we cannot do, how we do it, and why it costs what it does.
This past month we’ve been thinking a lot about words and the names we put on things. Like many of you, we’ve been confronted with a high number of patients confused by a deductible bill following what they mistakenly thought was a “preventative” visit.
Of course we in the industry understand how a preventative colonoscopy becomes diagnostic by the presence of polyps, but how could the general public understand this seemingly made-up insurance distinction?
The work was the same, the experience for the patient the same, but the elevated RVU by the risk of polyps now transforms the visit into one that carries out-of-pocket costs for the patient.
The New Yorker recently ran an excellent piece about the incomprehension of financial language and the harm it inflicts on society. The article contends that financial leaders wield power on those outside the industry through confusing language. No doubt the healthcare industry does the same to patients.
We know that when we receive an EOB from our personal insurance company we have trouble comprehending it, so how can we expect a patient who is not part of the industry to be able to understand?
As an industry, including providers, government agencies, and insurance payers, we have fundamentally failed at clearly communicating to patients, the public, about what we do, what we cannot do, how we do it, and why it costs what it does.
Perhaps we fail at this because we, ourselves, are mired by restrictive language. Case in point: There are physicians who are dismissive of or patronizing toward any non-physician.
We need a word to describe the ethnocentrism of medical doctors; MD-centric, physician-ist, or doctor-ism perhaps? From PAs and NPs who rightfully claim that their education, training, and licensure qualify them to contribute in a different but meaningful way to patient healthcare to MBAs who have the education and experience physicians lack to run healthcare organizations, MD-centrism is a threat to our healthcare system and the care we are able to provide to our patients.
Labels and what we call things shouldn’t, to educated and enlightened individuals, hide the true essence of what we’re discussing. As Shakespeare penned, "What's in a name? That which we call a rose/ by any other name would smell as sweet." Perhaps we need to add Romeo and Juliet and The Merchant of Venice to the physician curriculum to stress to physicians the critical importance of listening to a multitude of voices and those with education and experiences different than our own.