I would hope that 30 minutes to an hour spent helping the patient through the five stages of a life threatening experience would be very cost effective in the long term view. The managers of this managed care system would not care if the healthcare practicioner gave more time in these situations as long as it didn't impact their productivity profile adversely and as long as the practicioner did it as a donation of their own time. I don't know if such caring can be brought into the system in a general fashion. Perhaps if that happens and the costs of healthcare are predictable in large measure because all the healthcare practicioner costs are predictable there will be time for such compassion and caring because it will not be allocated to a per-minute cost to the system. Thus surgeons and oncologists should lead patients through the thickets of uncertainty in caring for malignancies and should never announce the unequivocal, got it all or cure .
Life is uncertain and healthcare is uncertain.
It is our job to guide and educate those that come to us so they may understand the realities of whatever situation they are in. It is our job to support them through this time of learning.