Dr. Butterly: Tell patients this will hurt

Butterly said he believes that he is much less likely to recommend cardiac catheterization than another cardiologist.

The unit cost will be higher, and the total cost of care for the patient catheterized could be either higher or lower, but the total cost of care for the patient population will be lower because of the low use of the procedure for that group of patients, Butterly said.

Dartmouth-Hitchock has always been low at using expensive medical interventions, but, today, because total medical expense figures are not reported in the same way as unit costs, total medical expense figures are much harder to find on the Internet, Butterly said.

Butterly also talked generally about policymakers’ approach to health care cost reform.

“One of the things that I see is that people are trying very, very hard to minimize the pain that I think we know is coming,” Butterly said. “One of the first lessons I learned in medical school was that, when you’re going to recommend something to a patient or you’re going to do something to a patient and it’s going to hurt, do not tell them, ‘It isn’t going to hurt.’ And, this is going to hurt.”

See also:

• New Hampshire schedules premium rate public hearing
• AHIP: There is Still Hope for Health Reform
• PPACA: Feds Eye Accountable Care Organizations