Dr. Aaron Carroll on Patient ‘Demands’

Published February 23, 2015

Dr. Aaron Carroll at The Incidental Economist discusses one of the more interesting topics in health care economics (he’s a doctor, not an economist, btw), the idea that patients often demand services, tests, and treatments that aren’t really necessary, and doctors often give in just to get the patient out of their hair. This is important in health care policy because people demanding unneeded care can contribute to rising health costs – somebody has to pay for that unneeded MRI, after all, and with today’s third party payer system there’s a good chance that somebody is all of us.

As Dr. Carroll points out, however, the research suggests this phenomenon is, if not non-existent, probably overstated. His ‘Healthcare Triage’ video today discusses this, and is worth the three and a half minutes it takes to watch.

One item I’d add – to the extent the problem does exist, one pretty obvious way to limit it is for patients to bear the cost of treatment more directly. I’m going to guess a patient is a lot more willing to heed the doctor’s advice when she says “You don’t need that, but if you insist then it will cost you $200” than when she says “You don’t need that” and leaves unsaid what the patient already knows in many cases, which is that the treatment is “free” or available for only a nominal charge.