When sickness strikes, which doctor do you choose to visit? If you’re like most, you’ll ask family members and close friends for recommendations for selecting the right doctor. If you’re ambitious, you’ll go web-hunting for reviews or even consult your insurance carrier for suggested providers in the area. Most people think these recommendations will find them the best doctor for costs and quality, but they would be mistaken.
Relying on word-of-mouth does not ensure you’ll end up in the right doctor’s office. For insurance carriers who give a list of suggested providers, their primary concern is not quality patient care. For your friends, most will be able to tell you if a doctor is friendly, but won’t be able to gauge medical competence. For websites that rate physicians, most don’t have enough visitors to give an accurate portrayal of a provider.
There’s so much you may overlook by relying on these limited sources of information. It’s doubtful that the doctor you find by asking around has the highest success rates, has a pleasant bedside manner, takes the time to get to know patients personally, has knowledge and expertise in their treatment field, maintains sanitary facilities, and most importantly, is cost-effective in their treatment decisions.
Frankly, we do more research when choosing our homes, cars, and universities than when selecting a doctor. The problem is a wrong choice of healthcare provider can end up costing us a lot more. Here’s why:
Unlike doctors in Europe, US doctors do not have fixed salaries. They benefit financially from running expensive tests on their patients and going through high-cost treatment plans. Don’t get me wrong– not all doctors are profit-maximizing machines. In fact, most of them genuinely care quite deeply about their patients. Still, when it comes down to individual care decisions, even the most empathetic doctor is faced with financial incentives that push them towards overtreatment and overly expensive tests.
Healthcare reform advocate David Goldhill finds that Medicare spends twice as much in Dallas, where there is a plentiful supply of healthcare providers per resident, compared to Salem, Oregon where physician supply is less abundant. Physicians who have fewer patients coming through their doors tend to order more tests and treatments to keep their practices full.
Physician overtreatment does not only arise from a pure profit motive, but also from fear of legal consequences. An entire industry of medical malpractice litigation has emerged, leading doctors to order more tests and procedures than is medically necessary. This behavior is primarily a protective measure against lawsuits or a phenomenon known as “defensive medicine
“Informational advantage” is the upper hand that healthcare providers naturally have over their patients, due to their extensive medical training. This knowledge gap gives authority to physicians. When the doctor tells us a specific test or treatment is truly necessary, we aren’t usually in a position to deny it. Also, doctors can quickly overwhelm their patients with too much confusing information, and on the other end of the spectrum, failing to provide enough info surrounding their treatment, leaving the patient blindly following orders.
Another realm where patients lack information is pricing: few people know exactly how much medical services will end up costing them. The health insurance system makes accurate prices for medical care unclear.
The combination of medical providers benefiting from high-cost treatments and patients’ disadvantaged informational position means that physicians can (to an extent) generate demand for their services at will, a phenomenon called physician-induced demand. Choosing the wrong doctor, one that regularly exhibits this type of behavior, is costing you even when you don’t realize it.
Do you find the commercials on TV promoting certain medications to be annoying? It turns out that doctors have it way worse. Pew Research reports that while pharmaceutical companies spent $3 billion in 2012 marketing to consumers directly (mainly through TV ads), they spent a crazy $24 billion marketing to physicians.
Pharmaceutical companies market to doctors through several methods. These range from free drug samples, mailings, web and journal ads, and most concerningly, “detailing,” whereby drug sales reps promote their products face-to-face to physicians and even go so far as taking them out for meals or giving them gifts. In 2016, there were a total of 71,000 pharmaceutical sales representatives in the US. That’s almost one for every 14 doctor’s in the USA.
In the same vein, you could end up with a physician that routinely prescribes expensive brand-name drugs. In some cases, these brand-name drugs may even be less effective than generic alternatives. What’s more concerning is the fact that most physicians are in the dark about the costs of the very drugs they prescribe. They lack the information to compare prices and effectiveness across drugs, leading them to write prescriptions for drugs they are most familiar with, AKA brand-names that are heavily marketed by pharmaceutical companies.
A ProPublica analysis guided by Harvard researchers reveals that doctors who receive payments or other rewards from drug companies prescribe different medications than doctors who don’t, and the more money a doctor gets from drug companies, the more likely they are to prescribe brand-name medications. In other words, many physicians have loyalties to the pharmaceutical industry and prescribe expensive brand-name drugs to show support to the companies that offer them education, gifts, and generous rewards for participating in promotional activities. We all know drug costs are rising, and avoiding specific doctors goes a long way to control these costs.
The right doctor is someone whom a physician would trust with the care of their own family. How then can we go about choosing the best doctor available who can meet our needs? A healthcare guidance platform may be just the answer.
HealthJoy uses both artificial intelligence as well as old fashion legwork to ensure that we recommend the best provider to our members. Our healthcare concierge does the deep digging using reputable and accurate sources so that you don’t have to break a sweat when looking for your next doctor – this takes an average of 1-2 hours per recommendation.
First and foremost, HealthJoy’s concierge verifies the objective facts. It looks at several indicators of a physician’s quality: we search state boards for lawsuits or other red flags, we make sure board certifications are up to date, and we are also wary of doctors who are heavily influenced by drug company payments. Next, we look at the number of referrals received by the provider, as well as the number of times they have performed a particular procedure. We also review the rankings of their medical schools/residency programs, and the number of years they’ve been in practice.
The next item on the list is cost-effectiveness. Choosing the provider with the best price has a massive impact on the savings earned by both yourself and your payor (your self-insured employer and/or insurance carrier), and we check prices for all parties involved.
We then go the extra mile to find a provider that fits your personal preferences, creating a recommendation that is highly-tailored to your individual needs. We consider everything from gender, language, and age preferences, to checking the physician’s distance from your location, in-network status, and scheduling availability.
Your friends may (or may not) be able to provide you with excellent restaurant recommendations, but most of them will not know how to assess a doctor’s medical competence and cost-effectiveness. The best doctor does not over treat their patients, leverage their informational advantage for financial profit, or prescribe medications based on loyalty to a pharmaceutical company. However, not every doctor exhibits these traits, which causes the cost of care to vary wildly between Physician A and Physician B.
It is intimidating to navigate through all these moving parts on your own, so we understand why a simple recommendation from your neighbor might be your desired method for choosing a doctor. As you’ve read, though, this shortcut will probably cost you. Thankfully, HealthJoy’s artificial intelligence-powered concierge uses an algorithm to compile all the essential details about a provider, so finding the best doctor is just one tap away on your smartphone.