Doctors at Jerusalem’s Hadassah Medical Center have received a surprising letter from the hospital director, Yuval Weiss, telling them that starting next month when they make prescriptions online, little dollar signs will appear by the drugs they order.
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The dollar signs aim to remind them of the cost of the treatments they are prescribing, Weiss said.
“The signs show the relative price of the medicine. The more expensive a medicine is, the more dollar signs will appear,” Weiss said in the letter, explaining that the initiative is designed “to enable doctors to make an informed choice of drugs, the clinical aspect to be considered in tandem with the economic aspect.”
The move comes as the famed medical center is experiencing an acute financial crisis, which has left it with a deficit of hundreds of millions of shekels. Hadassah is now in the throes of a financial recovery program led by Avigdor Kaplan, a healthcare and insurance executive. Putting dollar signs on online prescription forms is just one element of the cost-cutting initiative.
At this stage, the dollar signs are there just to serve as a gentle reminder. Nevertheless, staff at Hadassah who asked not to be identified predicted that eventually restrictions will be placed on costly prescriptions, as is the case at some of the health maintenance organizations today.
Even as this stage, however, the dollar sign initiative has aroused opposition from Hadassah’s medical staff.
“We really don’t like the direction this directive is taking,” said one senior physician. “True, right now they are not talking about allowing or banning prescriptions. It’s clear the letter was vetted by a legal adviser. But that is likely to be the next stage and it is clear what is expected from us.”
But Prof. Avinoam Reches, chairman of the Israel Medical Association’s ethics committee, said he understands the step. “The security of the patient comes before everything, of course, but if there is an equal choice in efficacy and results, the doctor needs to choose the less expensive alternative,” he said.