EXHIBIT 1.

Examples of physicians’ failure to address patients’ financial concerns

Example	Sample conversation
Failure to recognize potential financial concerns	PT: Is why we stopped stuff, because of the surgery. But I know there’s a new thing out for the, um, ulcer, besides the Nexium, because that’s so expensive. Expensive would be—
	DR: Um-hum. Let me see. We did use the methotrexate.
Distracted from patients’ financial concerns by frustration with system	DR: What else do we need? The Restoril? Folic acid?
	PT: Not the folic, and the Restoril…they won’t approve that one, either. I don’t know why.
	DR: Those insurance companies, they don’t want to pay.
	PT: I know.
	DR: For anything.
	PT: I also need the Tylenol 3.
	DR: [Writes prescription for Tylenol 3 but never returns to discuss inability to pay for Restoril.]
Dismissal of patients’ financial concerns	DR: We’ll see if the insurance company is going to pay for your BRCA [test].
	PT: How much does it cost if I have to pay for it?
	DR: Oh, we don’t want to talk about that.
Hasty acceptance of patients’ dismissal of financial concerns	DR: The Tykerb, we have not given you for a long time, and these are pills, if I remember correctly, you have tolerated rather well.
	PT: I think so. I think I did.
	DR: Okay, and your insurance had no problem paying for it?
	CG: Well, we paid yeah, they paid,
	DR: They paid?
	CG: Yeah, that was a lot of copay. But that’s okay. That’s not a problem.
	DR: Okay.

SOURCE Authors’ analysis of audiorecorded clinical interactions drawn from the Verilogue™ Point-of-Practice database.

NOTES BRCA is a genetic test for breast and ovarian cancer risk. CG is caregiver.