The Cost of Healthcare and the Ob/Gyn

The cost of health care has been a major topic in the news of late. The growth in public debt is due in no small part to inflation in the Medicare and Medicaid programs. As physicians, we always wish to do what we can to maximize our patient’s health. But is there any way to do this without increasing the price-tag of medicine?

One definition of cost is “The sacrifice involved in performing an activity, or following a decision or course of action.” There are costs associated with everything we do in gynecology, including inaction, so getting a true sense of what a surgery or medication “costs” is complex. Lucky for us, we are usually protected from having to decide what the cost of our care is unless confronted with cost of our time when we have to argue with an insurance company over a pre cert.

I wonder if doctors could help contain costs if they had a way of comparing their interventions. If you go to a grocery store, you compare costs by looking at a price tag (and the number of calories if you have food OCD).

Recently, my hospital system started to print charges for OR disposable instruments on the pick lists. I was thrilled – this let me compare the various laparoscopic gizmos and trochars that I use. At the risk of having the company reps tear up my business card, I think there is clinically little difference, so this addition of price let me do some comparison shopping.

How many of us have let cost considerations into the operating room? Is it imposed from the outside, or generated by the gynecologists themselves? Can we think about cost and still give good care?