Doctors are some of the most educated and celebrated people in modern society, and for good reason. They go to school for decades to learn the complexities of the human body and are able to heal the sick.
But even though they are experts on medicine, you, the patient, are the expert on… you. You know your body best – what’s normal and what’s not.
In addition, physicians are usually not experts on the cost of medicine. Medical billing and insurance are fields in and of themselves that require a different set of skills.
So if a visit to your doctor leaves you uneasy, ask for an explanation. Here are four valid reasons to question your doctor:
1. You’re told you need a costly imaging exam.
Imaging exams are among the most overused procedures in medicine, and the U.S. Food and Drug Administration estimates that 30 to 50 percent of them are not medically necessary. The overuse of these exams has consequences you might want to consider before agreeing to an X-ray, MRI or other imaging procedure.
First, there’s the risk of radiation exposure. While many imaging exams are one-time diagnostics, the overuse of ionizing radiation has nonetheless been called into question by the FDA. This type of radiation is used in CT scans and fluoroscopy, but not ultrasounds or MRIs, and there is reason to believe it may elevate cancer risk.
Even if the imaging exam in question isn’t one of these high-risk types, these procedures are almost always expensive. Base charges start around $200 for ultrasounds at the least expensive hospitals in the country, but run about $1,000 on average, according to 2013 Medicare data. Those prices are before insurance, but you’ll still be responsible for most of the cost if you haven’t yet met your deductible.
The third consequence of unnecessary exams is the unneeded exposure to the medical industry. The more procedures you undergo, the higher the chance for error. Errors include costly billing or coding mistakes, but they also include medication errors and accidental injuries, which can happen for even routine imaging exams. In 2009, there were 170,000 reported medical errors in the U.S., and nearly a third of all injuries each year are due to medical error.
You can find out whether you need an imaging exam that might cost you more than just a thousand bucks. First, ask your doctor if the test is absolutely necessary. If she gives you an unclear answer, ask if there are any alternative tests that might work. Get a second opinion if you’re still unsure.
2. You’re given a life-altering diagnosis.
While getting a second opinion on a diagnosis rarely results in a different opinion, you should always obtain one if you’re skeptical. The chances that a second doctor will disagree with your original doctor hover around 1 to 5 percent. Even so, a second opinion on a costly surgery or medication regimen often gives patients the confidence they need to proceed. This is especially important for diseases such as cancer and autoimmune disorders, which can be painful and costly to treat.
Second opinions are always in the patient’s best interest, so if your doctor is discouraging one, he or she may have ulterior motives. Even though they are in the minority, many doctors get kickbacks from drug companies or medical imaging facilities to refer patients. If a second doctor says you don’t need any of the items your regular physician suggests, consider a new regular physician.
Ideally, your doctor will provide you with referrals to specialists in his field, and most doctors are happy to do this. Like other professionals, they often talk to colleagues to get a better scope of their work.
When doctors have a patient in common, it benefits all parties for them to discuss your health. Two heads are better than one, as the saying goes. If your original doctor was incorrect about your diagnosis, the second can provide insight as to why, so the mistake won’t be repeated. Like many fields, practicing medicine requires continual learning to be done well, and great doctors know this.
3. You’re assured of something outside their control – like cost.
As smart as they are, most doctors know little of the ins and outs of insurance policies. They have high-stress, important jobs that often leave them with little down time. That’s all the more reason to take with a grain of salt anything your doctor says to assure you that you’ll be covered by health insurance.
Surveys evaluating physicians’ understanding of treatment costs and insurance show they would like to understand more. Even so, the current knowledge of costs of care and health insurance is low among physicians. Less than a quarter can guess their hospitals’ charge for 15 common procedures within 25 percent of the true price.
If you’re assured that you’ll be able to afford something, or cost is downplayed, you should consider the possibility that your doctor is disconnected from health costs. Whenever possible, double-check prices and insurance coverage with billing personnel before agreeing to a test or procedure. It’s their job to know costs and health insurance information, not your physician’s.
4. You’re uncomfortable.
Open communication and confidence are key to the doctor-patient relationship, so question anything that undermines that rapport. Great doctors listen to concerns, ask enough questions to solve patient problems and are honest and sincere. Research has shown that when doctors are attentive and empathetic, outcomes are better for their patients.
A doctor who’s rude, doesn’t listen or makes you uncomfortable isn’t on your side. Most doctors care about their patients and want to do their job well. If your doctor ever makes you feel uncomfortable, it may be time to find a new one.