Mark Melrose, DO, is the Chief of Emergency Services at NYC Health + Hospitals’ North Central Bronx Hospital, a New York City safety-net hospital with 232 beds and more than 50,000 annual emergency room visits. Much of the care delivered by the organization is covered by government or commercial payers, and patients are usually unaware of the full cost. Melrose says it would be easy for him to assert that cost shouldn’t be a factor in the value equation and should remain hidden to patients and physicians alike. However, he considers that an irresponsible attitude, one that that winds up squandering the limited resources available in health care today.
The question of cost of care and physician responsibility is the central theme of the first of three NEJM Catalyst Buzz Surveys focused on value in health care. Sponsored by University of Utah Health, the survey was conducted among the NEJM Catalyst Insights Council. Among other findings, the survey results show a disconnect: Physicians feel responsible for the cost of care to a patient, but not accountable for it.