Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Article Comments (2)

What Medical Condition Is The Most Costly To Employers?

Ok…here’s a brain teaser.  What medical condition is the most costly to employers?  I’ll give you a hint.  It is also a medical condition that is likely to go unrecognized and undiagnosed by primary care physicians.

If you guessed depression you are correct. If you mentioned obesity you get a gold star since that comes in right behind depression for both criteria…at least in terms of cost and the undiagnosed part.

Four out of every ten people at work or sitting in the doctor’s waiting room suffer from moderate to severe depression.  Prevalence rates for depression are highest among women and older patients with chronic conditions.  Yet despite its high prevalence and costly nature, depression is significantly under-diagnosed (<50%) and under-treated by physicians.

For employers, the cost of depression cost far exceeds the direct costs associated with its diagnosis and treatment    As the graphic above indicates, the cost of lost productivity for on the job depressed workers (Presenteeism) and lost time for depressed workers that are absent from the job (Absenteeism) far exceed the cost of cost of treatment (medical and medication cost).

Since I first addressed depression in an earlier post, I have identified what I believe to be the central reason why depression continues to go undiagnosed and untreated in primary care.   The reason is that physicians are uncomfortable talking to patients about it, e.g., psychosocial issues.   Even when patients provide “cues” suggesting evidence of depression in the opening statement, i.e., I have been sleeping well, I haven’t been myself lately, etc., evidence suggests that physicians are likely to simply not recognize or ignore the cues.   Physicians themselves admit that their training predisposes them to be more comfortable dealing with biomedical versus psychosocial issues.

Now think Accountable Care Organizations and Medical Homes.  Both of these concepts, one a payment reform model and the other a delivery model, are predicated upon the notion that the medical services offered have real value to the payer, e.g., employer or health plan.  But what kind of value are primary care physicians providing when they fail to diagnose and treat the biggest problem facing the people that ultimately pay for their service?

Tying this all back to physician-patient communications, physicians need to begin employing more patient-centered communication techniques in their dealing with patients.  In particular, physicians need to do a better job listening to what their patients are trying to tell you, even if it is outside your comfort zone.   At the very least you can refer the patient to a counselor for help.  In so doing you will be clearly helping the patient and adding real value to the people who ultimately pay for your valuable service.

That’s what I think.  What are your thoughts?

Source:

Sherman, B., et al. Patient-Centered Medical Home and Employer Metrics. Patient- Centered Primary Care Collaborative

*This blog post was originally published at Mind The Gap*


You may also like these posts

Read comments »


2 Responses to “What Medical Condition Is The Most Costly To Employers?”

  1. Health Blog says:

    Yes, depression can reduce productivity of the employee as well as increase the cost of treatment. Whatever the job may be, depression can reduce performance, unlike obesity and other medical problems.

  2. Ann Becker-Schutte, Ph.D. says:

    Thank you for this post! I’m always encouraged when I hear physicians recognizing mental health issues. It’s a happy day for me when I can coordinate care with health care professionals.

Return to article »

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

Read more »

How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

Read more »

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

Read more »

Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

Read more »

See all book reviews »