The Impact of Cost Conversations on the Patient-Physician Relationship

Health Commun. 2019 Jan;34(1):65-73. doi: 10.1080/10410236.2017.1384428. Epub 2017 Oct 20.


Previous research has suggested that fear of harm to the patient-physician relationship is an important barrier to conversations about cost of care. However, few experimental studies have investigated the effects of cost of care conversations on the patient-physician relationship, particularly from the patient's perspective. In the current research, we take an experimental approach to investigate patients' attitudes and preferences for a hypothetical physician who discusses cost versus one who does not. Across three studies, using data from both the general population and cancer patients, we find that people prefer a hypothetical physician who discusses cost over one who does not (Pilot Study, Studies 1 and 2). In addition, we find that people use cost information to inform their hypothetical treatment decisions without changing their attitudes toward the physician who includes this information (Study 1). Finally, we examine how and when cost information compares to more traditional medical information (e.g., side effects; Study 2). We discuss the implications of this research for cost communications and the patient-physician relationship, highlighting that cost conversations may not be as harmful as previously thought.

MeSH terms

  • Adult
  • Attitude
  • Communication*
  • Cost-Benefit Analysis
  • Female
  • Health Expenditures*
  • Humans
  • Life Expectancy
  • Male
  • Middle Aged
  • Physician-Patient Relations*
  • Pilot Projects
  • Risk Assessment
  • Severity of Illness Index