Getting the Best Care

When your doctor suggests you get an MRI or a stress test or start preparing for knee replacement surgery, you might ask:

1)   How much will this cost?

2)    Where will I get the best care?

3)    What if I feel more comfortable going to the hospital with the best reputation, even the quality scores are the same and it is more expensive?  Isn’t peace of mind worth something?

Many doctors, nurses or the nice people at the front desk don’t know the cost of tests or procedures, but they may be able of offer guidance. 

Lynda Young, M.D., President, Massachusetts Medical Society

We have suggestions about how to use that guidance from Lynda Young, M.D, president of the Massachusetts Medical Society.

1)    If my doctor doesn’t know how much a test will cost and whether the care is better at one hospital than another, should I ask these questions during an office visit?

Yes, you should ask these questions. Your physician can discuss with you which are your best options and he/she can educate themselves on the cost and quality issues by researching various resources that are available on these topics.

2)    What do I do if my doctor tells me to go to a hospital that I know, or expect, will cost me more than another?

There may be reasons why your physician is recommending a particular hospital and this conversation is important for you both. Asking about the cost and quality of care at one hospital versus another is a practical way to decide on what is best for you.

3)    I’m embarrassed to tell my doctor that I am shopping for care rather than taking his or her advice without question.  Will my doctor be angry and will I risk receiving worse care if I question their recommendation?

Don’t be embarrassed about these questions. Most physicians would appreciate their patients taking an interest at this level. After all, it is your health and frankly your dollar on the table. The more informed both you and your physician are, the better your care.

4)    How do doctors decide where to send their patients for tests or surgery?

Often, physicians will use a hospital or surgical site where they have close relationships with the specialty physicians. This relationship means good communication between the referring physician and specialist and patient besides quality and cost concerns. Decisions about which lab to use may depend on what insurance you have, where the labs are located and whether that lab has expertise in certain instances, such as can they draw blood samples from infants.

Thanks Dr. Young.  We have a few final thoughts about starting to shop for care:

Hospitals and labs don’t post prices, but we know they vary a lot.  You will find some of the price differences in this report from Attorney General Martha Coakley.  This same report says there is little difference, on average, in the quality of care at hospitals inMassachusetts.  Check our “Resources” page for sites that compare the quality of care.

And finally, the price of health care may vary based on your insurance plan or whether you have any.  Insurance companies negotiate separate contracts with hospitals and physician groups, so the “price” of an MRI at one hospital will be different for Blue Cross, Harvard Pilgrim or Tufts HealthPlan members.  Uninsured patients are typically charged more for everything than are patients with insurance.

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