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Doctor calls for action on 'crazy' health costs



Should doctors play a role in the push for greater transparency in health costs?
Should doctors play a role in the push for greater transparency in health costs?
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As it turns out, even doctors are shocked by the wide variation in charged prices for certain medical procedures.

Dr. Stephen Rakower was the chairman of several surgery departments in Orange County before he retired in 2010. In his career, he told me, he ordered several thousand ultrasounds and CAT scans.

But it wasn't until recently, when a relative needed a radiology procedure, that he learned there exists a wild variation in charges for many common procedures, like mammograms and back MRIs. And, he learned, patients typically don't know how much of the bill they'll be responsible for until long afterward.

He reached out to our ongoing #PriceCheck project to say that he – and most likely other doctors, too – has no idea how widespread and deeply ingrained this phenomenon is.

"I think it would be unlikely that any physician has an idea of the cost of services in his neighborhood," Rakower told me.

There should be more transparency surrounding the charged price for procedures and the consumer's share of that bill, he said, pointing specifically at radiology.

I asked him: If he’d known about the variation in prices while he was still practicing medicine, would he have done anything differently? He says no, because "I don't think doctors should be involved in the financial planning of health care. If you do that, then you're managing money and not managing patients."

But patients should have access to price information, he says. He says electing a medical procedure should be like choosing a gas station: Drivers know how much each type of gas costs, before they purchase it.

And doctors should be advocates for greater cost transparency across the health care system, Rakower says.

He says doctors can encourage organizations and government agencies to require facilities to publish the charged prices for their procedures. And, he says, they could take a stand, by not referring patients to facilities that don't publish these charged prices, and don't inform patients of their share of the bill.

The situation, he told me, is "crazy – and nobody's doing anything about it." You can read more about Dr. Rakower's call for health costs transparency on the blog of our #PriceCheck partner, ClearHealtCosts.com.

Health professionals, we want to hear from you: Are you aware of the wide variation in prices for common medical procedures? Does this knowledge affect which procedures you recommend to your patients, or which facilities you refer them to? Are you interested in joining the fight for greater transparency in health costs? Tell us about it in the comments section below, or e-mail us at Impatient@scpr.org.