“In my third week as a medical intern, I learned a vital lesson about the realities of everyday medicine that textbooks and professors hadn’t taught me: how profoundly the financial cost of care affects patients,” Henry Bair writes over at Stat. “I was caring for a man admitted to the hospital with uncontrolled atrial fibrillation, an irregular and often rapid heartbeat. After much deliberation, I prescribed a new anticoagulant to prevent the formation of blood clots in his heart, instructed him to continue using his current drugs to keep his heart rate steady, and arranged a much-needed appointment with a primary care provider. It was a rather routine proposal; my patient nodded in understanding as I presented it. Nonetheless, I felt a sense of satisfaction at having developed my first comprehensive discharge plan. My complacency evaporated the next day when I called him to follow up and he began to berate me. His pharmacy had told him the medications would cost him more than $400 each month, an amount he couldn’t afford. When I asked my patient how he had been managing his past medications, he revealed that he had, for months, been halving the dose of his antiarrhythmic medicines to extend his prescription and save money. It occurred to me then that this practice had likely led to this recent hospitalization. I was stunned by how ill-equipped I was to offer even a single piece of advice to help my patient navigate the financial barriers to his health care.” Henry Bair, “Cost counseling and stewardship need to be part of medical school curricula,” Stat.
