Healthcare costs are increasing for patients. Choosing Wisely is an initiative of the American Board of Internal Medicine (AIMB) Foundation in partnership with Consumer Reports to promote conversations between physicians and patients to avoid unnecessary tests, procedures, and medications. The Choosing Wisely Initiative developed the resource “Five Questions to Ask Your Doctor” to support patient engagement in cost conversations and empower patients to ask questions about what care is right for them. The purpose of this study was to understand patients’ response to the “Five Questions”. Four focus groups were conducted in English and Spanish in rural and urban communities in Central California. Participants represented an ethnically, racially, and socioeconomically diverse sample (including those who are below the 400% Federal Poverty Level), and those who were between 30 and 64 years of age. In each focus group patients provided information about their individual healthcare costs, completed a scenarios survey, watched a patient/doctor interaction video, and responded to the “Five Questions”. Analysis of the interview transcripts focused on the following: identifying overarching themes, identifying ways to tailor messages to patients, and characterizing themes of preservation of trust during cost-of-care conversations. Patients’ trust in the authority of their doctor was a common theme across participants that reoccurred throughout the interview. Other themes included asking about options, variable quality of care, limited time with their doctor, educating yourself, and self-advocacy. Results suggest that the “Five Questions” to ask your doctor is an effective approach to promote patient-doctor conversations about cost and self-advocacy among patients.


Susan Perez

Lab site

California State University, Sacramento (Sac State)

Funding Acknowledgement

The 2017 STEM Teacher and Researcher Program and this project have been made possible through support from Chevron (www.chevron.com), the National Marine Sanctuary Foundation (www.marinesanctuary.org), the California State University Office of the Chancellor, and California Polytechnic State University, in partnership with California State University, Sacramento.



URL: https://digitalcommons.calpoly.edu/star/447


To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.