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The Boston Globe

Ideas

Should doctors consider medical costs?

The price of care can hurt health, and some say physicians have a responsibility to treat patients accordingly

This patient could be a time bomb, Dr. Neel Shah thought. A blood test suggested that she might have an ectopic pregnancy, in which a fertilized egg remains outside the uterus. Left untreated, the condition can cause fatal hemorrhaging. But when Shah, a medical resident at the time, told the woman she needed an ultrasound to confirm the result, she refused. An earlier visit to the emergency room for a bout of stomach trouble had left her with an exorbitant bill. Until Shah could tell her how much an ultrasound would cost, she wasn’t budging.

He had no idea what an ultrasound cost, and it took him a day to find out from the hospital. “All the while I was worried she could bleed to death,” Shah says. After telling the woman the test would cost $650, she agreed to be scanned. Shah’s suspicion was confirmed and the woman was successfully treated.

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