When do doctors stop looking like healers and start seeming like salespeople? The answer lies in how they discuss the cost of care, according to a UC Berkeley Sociology study.
In Berkeley Sociology Professor Eliza Brown’s recent paper, “Doctor, how much does it cost? Moral values and price talk in a stratified consumer medical market,”she explores how doctors talk about money differently in various fertility clinics.
Past research claimed that doctors in the same specialty discuss the cost of treatments in a similar way, but that’s not what Professor Brown found. Instead, some medical providers are not direct in discussing the price of treatment and believe money and medicine should be kept separate — while others are more open and try to help patients find ways to save money for treatments.
Professor Brown found that at physician-owned clinics serving upperclass people, called "Boutique Clinic,” doctors avoided talking about the cost of care, relying on phrases like “very, very expensive.” But, at cheaper clinics for working-class and lower income people, called “Budget Clinic,” doctors clearly explained the costs and tried to make care affordable.
At another type of clinic called “University Clinic,” which also serves upperclass patients, doctors are transparent with prices. Brown said that’s because the doctors don’t own these types of clinics and do not set the prices of treatments, so they don’t mind talking about the costs.
According to Brown, the way doctors talk about money depends on what patients they serve and whether they own the clinic. Some doctors want to avoid looking like they’re just trying to make a profit from selling care, so they avoid talking about prices or are very open about it.
“In this era in which trust in medicine is in question in no small part because of the perception of physicians' pecuniary interest in selling more care, it's critical to consider how physicians talk about the price of medical care with patients,” Brown said.
Brown added that the way doctors talk about cost of care plays a big role in maintaining or losing patient trust. If doctors are too quiet about prices, some patients might wonder if they’re hiding something. However, if doctors are too pushy about money, patients may feel like they’re being tricked into spending more money.
Finding that balance requires understanding the type of patients the clinic serves and considering whether the clinic is doctor-owned.
“There is not one moral value guiding the 'right' way to talk about money with patients,” Brown said.
