Nav: Home

Half of primary care doctors provide unnecessary specialty referrals upon patient request

January 06, 2016

A study recently published in the American Journal of Managed Care found that more than half of primary care providers reported that they made what they considered unnecessary referrals to a specialist because patients requested it. Many physicians said they yielded to patient requests for brand-name drug prescriptions when cheaper generics were available. This study was conducted by Sapna Kaul, assistant professor of health economics in The University of Texas Medical Branch at Galveston department of preventive medicine and community health, in collaboration with researchers from the Massachusetts General Hospital and Harvard Medical School.

Thirty percent of U.S. health care expenses each year are thought to be unnecessary. Physicians are increasingly expected to consider the costs of their treatment plans on the health care system when making medical decisions. However, little is known about how physicians balance cost-saving expectations in the face of patient requests.

Specialty referral rates have more than doubled in the last decade, raising questions about what is driving this pattern. Recent research shows that almost half of physicians report at least one patient request per week for what a doctor considers an unnecessary test or procedure.

In this study, researchers used data from a nationally representative survey of 840 primary care physicians in family practice, internal medicine and pediatrics.

In response to patient requests, 52 percent of the surveyed physicians reported making what they considered unnecessary referrals for a specialist and 39 percent prescribed brand-name drugs despite generic alternatives. Family physicians and internal medicine physicians were more likely than pediatricians to prescribe brand-name drugs and make unnecessary referrals. Other factors of giving into to patient demands included interactions with drug/device representatives, more years of clinical experience, seeing fewer underinsured patients and medical practices with only one or two physicians.

"Unnecessary medical practices may cause unneeded emotional and financial stress for patients and their loved ones," said Kaul. "Both physician and patient-level strategies are required to limit wastage of medical resources. Efforts to reduce unnecessary practices could include educating physicians about the benefits that result from avoidance of over/under use of medical services and implementing incentives to create a system of value seeking patients."
-end-
Other authors include Anne Kirchhoff from the Huntsman Cancer Institute at the University of Utah; Nancy Morden from The Dartmouth Institute for Health Policy; Christine Vogeli from Massachusetts General Hospital and Eric Campbell from both Massachusetts General Hospital and Harvard Medical School.

University of Texas Medical Branch at Galveston

Related Health Care Articles:

Care management program reduced health care costs in Partners Pioneer ACO
Pesearchers at Partners HealthCare published a study showing that Partners Pioneer ACO not only reduces spending growth, but does this by reducing avoidable hospitalizations for patients with elevated but modifiable risks.
Health care leaders predict patients will lose under President Trump's health care plans
According to a newly released NEJM Catalyst Insights Report, health care executives and industry insiders expect patients -- more than any other stakeholder -- to be the big losers of any comprehensive health care plan from the Trump administration.
The Lancet: The weaponisation of health care: Using people's need for health care as a weapon of war over six years of Syrian conflict
Marking six years since the start of the Syrian conflict (15 March), a study in The Lancet provides new estimates for the number of medical personnel killed: 814 from March 2011 to February 2017.
In the January Health Affairs: Brazil's primary health care expansion
The January issue of Health Affairs includes a study that explores a much-discussed issue in global health: the role of governance in improving health, which is widely recognized as necessary but is difficult to tie to actual outcomes.
Advocacy and community health care models complement research and clinical care
Global lung cancer researchers and patient advocates today emphasized that new models of delivering care and communicating about cancer care play an important role in the fight against lung cancer.
More Health Care News and Health Care Current Events

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Teaching For Better Humans
More than test scores or good grades — what do kids need to prepare them for the future? This hour, guest host Manoush Zomorodi and TED speakers explore how to help children grow into better humans, in and out of the classroom. Guests include educators Olympia Della Flora and Liz Kleinrock, psychologist Thomas Curran, and writer Jacqueline Woodson.
Now Playing: Science for the People

#534 Bacteria are Coming for Your OJ
What makes breakfast, breakfast? Well, according to every movie and TV show we've ever seen, a big glass of orange juice is basically required. But our morning grapefruit might be in danger. Why? Citrus greening, a bacteria carried by a bug, has infected 90% of the citrus groves in Florida. It's coming for your OJ. We'll talk with University of Maryland plant virologist Anne Simon about ways to stop the citrus killer, and with science writer and journalist Maryn McKenna about why throwing antibiotics at the problem is probably not the solution. Related links: A Review of the Citrus Greening...