Money Talks (But Do We?): Evaluating Perceptions and Practices of Financial Conversations by Cystic Fibrosis Clinicians

BACKGROUND: People with cystic fibrosis (PwCF) face considerable burden from medical expenses, medications, and daily living with a chronic disease. PwCF want to discuss financial challenges with their care team, although little is known about cystic fibrosis (CF) clinicians discussion practices. We described the current practices and perspectives of CF clinicians regarding cost and financial discussions. METHODS: We administered a national, cross-sectional, online survey to CF clinicians through CF Foundation listservs. RESULTS: 192 respondents completed the survey and represented all multidisciplinary team members such as licensed practitioners, social workers, nurses, pharmacists, and other involved disciplines. Most respondents (80%) believed CF clinicians should discuss costs of medical care although less than half felt comfortable discussing cost. Social workers were more likely than licensed prescribers to discuss costs and feel comfortable with discussions. 52% of respondents reported having at least one conversation about the annual cost of CF medical care and 73% discussed out-of-pocket costs in the last year. Social workers were identified as the clinician that should be primarily responsible for discussing financial matters. Lack of time during visits (77%), lack of knowledge about topics (74%), and lack of clinician comfort (64%) were the most commonly identified barriers to discussions. CONCLUSIONS: Most CF clinicians believe that cost and financial discussions are important and reported engaging in these conversations with patients at least annually. Differences in comfort level and discussion practices were observed between social workers and licensed prescribers. Results demonstrate the opportunity for educational interventions to address clinician knowledge and improve comfort level with discussions.