By Dr. Brian McDonough, Medical Editor

PHILADELPHIA (CBS) – There are many new treatments for a wide vvariety of chronic diseases that are not only extending lifespans but making a very real difference in overall health.

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The good news is that the treatments are helping. The bad news is that certain major issues, like the cost of treatments and diagnostic tests and the side effects of treatment are not often discussed in detail.

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A new report in The New England Journal of Medicine has found that physicians need to talk more about these issues. This is important because as recently as 2011, a third of all families were struggling to pay their medical bills.

Another key step is not just discussing these issues but working with the patients to come up with less expensive options and weigh the risks versus benefits of all the issues.

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Social workers who specialize in health care can have a crucial role in providing support.