Why Should Everyone – Consumers and Doctors Alike – Care about Transparency in Healthcare?

The Infamous Bill[/caption]

Our goal at HuliHealth is to combat the lack of transparency inherent in the global healthcare industry.  But why should you even care? Why is transparency in healthcare services so important?

To be more precise, by transparency I’m specifically referring to transparency in 1) cost of the medical procedures, 2) quality of care and 3) doctors’ credentials.

1) Transparency of medical procedure costs

Lack of transparency in treatment costs is definitely one of my hot buttons. Approximately two months ago, I went to the doctor for a yearly physical.  Even though I’m covered under my wife’s health insurance plan, I asked the medical staff how much the exams would cost me. After many strange looks, the staff told me that they didn’t know how much it would cost me, but not to worry as I was insured. I continued to ask them about the costs as I knew I had a high deductible plan, and that I would be paying the majority out of my own pocket. After a 15 minute discussion, and still no clear response, I started to get upset. How is it possible that they don’t know how much they charge for a physical? I was about to leave the doctor’s office and, in a last attempt to keep my “business,” the staff conceded and told me to expect a bill between $100-$150. To make a long story short, I received a bill for $527.85 (see above). Let me stop here as I still get pretty darn upset just writing about this…

Why should you care? Let me be clear – I know that going to the doctor is not the same as going to the mechanic. Good health is priceless. With that said, it is still unfathomable to me why health providers are not more transparent about costs. If I would’ve known about the $527.85 bill ahead of time, I would have certainly looked into other options. I’m 100% certain that I would have found a better doctor at a lower price.

Why should doctors care? To keep patients like me happy. (I will certainly not be returning to that doctor).

Solution: Pricing on medical procedures should be disclosed to patients upfront. I know this is not a simple feat (complexity behind insurance plans, medical unknowns, etc.), but the current system can definitely be improved. If the majority of doctors/hospitals around the world are already being transparent on pricing, why can’t it be done in the US?

2) Transparency in quality of care

How do you find a good doctor in a time of need?  I am fortunate to have a family of physicians that can refer me to great specialists. But what if you aren’t that lucky? Even if a general practitioner refers you to a specialist, how do you know if a doctor is good? Do you look at the doctor’s education? This is not a bad approach, but we all know that attendance at a great university does not necessarily result in a great doctor. Another option is looking at online doctor aggregator sites such as Yelp for ratings and reviews.  These sites do provide some valuable insights, but the doctor information is somewhat sparse and some of these reviews can be dodgy. At the end of the day, the more information that is available to you in making your doctor selection, the better.

Side Note: What does it even mean to be a “good doctor”? “Good” is such a subjective term. Is the doctor technically good? Does he/she have good bedside manner? Is he/she punctual? What is good to a 35 year old Chicagoan might be vastly different from a 65 year old Costa Rican.

Why should you care? Simply put, when it comes to your health, you want access to the best doctors. There should be a better way to identify the doctor that is the right fit for you.

Why should doctors care? The best doctors will welcome feedback. They understand that information is not their enemy, it is simply a tool to be used to provide better care for their patients.

Solution: Verified, patient-generated reviews and the ability to connect with previous patients. Reviews are an imperfect science, but they do provide an additional data point (more data is always better). Additionally, having access to relevant data from patients before you (e.g., were they happy with the results? How was their experience?) is very valuable. (On October 5th, the HuliHealth team attended a great event organized by Health 2.0 Chicago http://chicagohealthtech.org/ in which the merits and deficiencies of ratings and reviews were hotly contested).

3) Transparency in doctors’ credentials

Just in case you were wondering, by transparency in doctors’ credentials, I’m not referring to cases in which people use false credentials to impersonate doctors; these occurrences are few and far between (http://www.nytimes.com/2002/07/27/nyregion/li-man-accused-of-impersonating-a-doctor.html).  A more common situation, and an entirely legal one at that, is one in which doctors “embellish” their credentials to offer medical procedures that don’t fall under their realm of expertise.  As an example, a general dentist – without any proper training on dental implant placement – can tout on his website how his expertise in dental implants is “unrivaled” in the region.  Although I am certain some general dentists can provide better quality care than some dental specialists, I don’t think it is correct for a dentist without the relevant training to mislead – through marketing gimmicks – a patient into undergoing advanced treatment.

Why should you care? Nobody likes being misled. When it comes to your personal health, you want the doctor with the right training to address your specific health needs.

Why should doctors care? Doctors spend years in training for a reason. Having untrained practitioners performing complex procedures is not only fundamentally wrong, but also bad for business.

Solution: Convenient access to verified credentials (with easy to understand explanations about credentials and their respective relevance). Verified credentials will help consumers make informed decisions resulting in better care.

by Alejandro Vega