Now that costs are driving more of our healthcare decisions, one issue that keeps coming up is whose responsibility is it to initiate the cost conversation -- the patient or the provider? Recently, I heard a patient story about a prescription for acne that was $400. She didn't know the cost until she went to pay at the pharmacy counter. Refusing the prescription, the patient called the doctor's office and said that the drug he prescribed was too expensive and asked if there was an alternative drug choice. The nurse said there was, but that it needed to be taken twice a day instead of once a day. The cost for this prescription was $20. The patient was upset that no one in the doctor's office or at the pharmacy bothered to mention the cost of the drug beforehand.
There are many stories about doctors broaching the cost conversation before prescribing a drug or treatment as well as others that end with the surprise bill. But it seems that if we're going to be compliant patients and ask for care that is dependent on our ability to pay for it, then we have to own some of the responsibility for the cost conversation. We can't truly take control of our healthcare spending and family budget, if we aren't willing to take control of the conversation. Therefore, if the doctor doesn't bring up the cost of a treatment, then make a promise to yourself that you will, and be done with sticker shock.