Oncologists’ Attitudes Toward Cost Conversations and How They Affect Practice

Study findings suggest not all oncologists view cost conversations as a best practice, and framing these conversations as a strategic tool to encourage optimal decision-making, professionalism, and the therapeutic relationship can improve attitudes around these conversations (JCO Oncol Pract. 2021; OP2100042. doi:10.1200/OP.21.00042).

“Patients' desire for cost conversations exceeds the incidence of such conversations, and many oncologists report avoiding cost conversations despite reporting willingness to have them,” wrote Allison Scott, PhD, Department of Communication, University of Kentucky, Lexington, KY, and colleagues. 

Dr Scott and colleagues aimed to analyze attitudes toward cost conversations among oncologists, and their effects on practice.

One-on-one Interviews were conducted with oncologists practicing in Kentucky, where participants were asked about their attitude toward cost conversations, as well as their experience toward cost conversations. Participants were asked to provide advice for discussing cost with patients.

These interviews were transcribed, and themes were identified using qualitative descriptive analysis.

This study included feedback from 32 MDs who were between the ages 31 and 77 years, and more than half were male (68.8%). Participants were board-certified in medical oncology (53.1%), surgical oncology (25.0%), or radiation oncology (21.9%), and divided into two groups, based on whether they viewed cost conversation as best practice.

Among participants, 37.5% viewed cost conversations as best practice and reported pursuing such conversations (Group 1), while 62.5% who viewed cost conversations as not best practice and reported avoiding them (Group 2).

There were 3 parallel themes identified for each category in this study. The authors found that cost conversation attitudes and practice were based on making good treatment decisions, being a good clinician, and having a good relationship with patients.

“Not all oncologists view cost conversations as best practice,” wrote Dr Scott and colleagues, concluding, “To improve cost conversation attitudes and practice, cost conversations can be framed as a strategic tool that—when used well—fosters optimal decision making, professionalism, and the therapeutic relationship.”—Marta Rybczynski