Nav: Home

Many physicians make lack a firm understanding of the costs of medical tests & procedures

May 17, 2016

In today's health care climate, physicians are increasingly being asked to do their part to help contain costs and to "choose wisely" when it comes to ordering costly medical tests and services. However, a recent study led by researchers from The Dartmouth Institute for Health Policy and Clinical Practice found that while the overwhelming majority of physicians surveyed (92.2%) felt that doctors had a responsibility to control costs, less than half of the physician-respondents (36.9%) reported having a firm understanding of the costs of tests and procedures to the health care system.

The study, published in the American Journal of Managed Care, was designed to test physicians' awareness and knowledge of Choosing Wisely, an initiative of the American Board of Internal Medicine (ABIM) Foundation. The Choosing Wisely campaign was created in 2012 to help physicians better identify low-value health care services, or those that give patients little real benefit for the time and money spent.

As part of the campaign, the ABIM Foundation and partnering specialty societies create and publish lists of evidence-based recommendations, "Five Things Physicians and Patients Should Question," that help doctors and patients have more productive discussions about appropriate care based on a patient's individual situation.

Regarding physicians' attitudes toward/knowledge of low-value health services and the Choosing Wisely campaign, the study found:
  • Approximately one-third of physician-respondents felt it was unfair to ask doctors to be both cost-conscious and concerned with patient welfare, and approximately one-third also say they try not to think about costs during treatment decisions. About a third also stated that doctors are too busy to worry about costs.
  • Primary care physicians reported significantly greater awareness of the Choosing Wisely campaign than (47.2%) than medical specialists (37.4%) and surgical specialists (27%). Three-fourths (75.1%) of primary care physicians reported agreeing or somewhat agreeing that Choosing Wisely empowered them to reduce use of unnecessary tests and procedures as compared with 64.4% of medical specialists and 54% of surgical specialists.
  • Primary care physicians reported feeling significantly more pressure from patients to order tests and procedures than medical and surgical specialties (68.3%, 58%, 55.8% respectively). They also report feeling more pressure to refer patients to consultants (65.3% vs 34.7% in medical specialties and 33.7% in surgical specialties.) Conversely, surgical specialists were more concerned with malpractice than primary care physicians or medical specialists.

To conduct the study, the researchers created a 29-item Survey on Overuse and Knowledge of Choosing Wisely and distributed it to all doctors practicing at Atrius Health -- the largest ambulatory care provider in Massachusetts, serving nearly a million patients. Atrius is also a Pioneer Medicare accountable care organization.

Although the study was limited to Atrius clinicians, lead author Carrier Colla, PhD, says the findings reveal some important takeaways regarding health care cost containment and low-value care.

"Our analysis points to the fact that there is willingness on the part of physicians to forgo low-value care services, if they have appropriate support that addresses patient demand, malpractice concerns, and other drivers of overuse," Colla said. "But, it's also clear that to get a meaningful reduction in the use of low-value services, we need to engage more than just physicians. The behavior and attitudes of patients, regulators and other stakeholders all play a part in the consumption of the these low-value services."

The Dartmouth Institute for Health Policy & Clinical Practice

Related Primary Care Physicians Articles:

Primary care physicians outline barriers to managing chronic kidney disease
On July 10, 2019 the Department of Health and Human Services (HHS) announced they were aiming to reduce the number of Americans developing end-stage renal disease by 25% by 2030.
How primary care physicians can make Astana work
The Astana Declaration, adopted by the World Health Organization in October 2018, acknowledges the importance of primary health care to achieve better health outcomes globally.
A new approach to primary care: Advanced team care with in-room support
In this special report, the authors argue that the current primary care team paradigm is underpowered, in that most of the administrative responsibility still falls mainly on the physician.
New tool measures primary care as a whole
There are a number of measures to assess aspects of primary care, but a new measure breaks new ground by combining experiences of patients, clinicians, and payers and allowing the most informed reporter -- the patient -- to assess vital primary care functions that are often missed.
Large federal program aimed at providing better health care underfunds primary care
Despite a mandate to help patients make better-informed health care decisions, a ten-year research program established under the Affordable Care Act has funded a relatively small number of studies that examine primary care, the setting where the majority of patients in the US receive treatment.
More Primary Care Physicians News and Primary Care Physicians 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

Rethinking Anger
Anger is universal and complex: it can be quiet, festering, justified, vengeful, and destructive. This hour, TED speakers explore the many sides of anger, why we need it, and who's allowed to feel it. Guests include psychologists Ryan Martin and Russell Kolts, writer Soraya Chemaly, former talk radio host Lisa Fritsch, and business professor Dan Moshavi.
Now Playing: Science for the People

#537 Science Journalism, Hold the Hype
Everyone's seen a piece of science getting over-exaggerated in the media. Most people would be quick to blame journalists and big media for getting in wrong. In many cases, you'd be right. But there's other sources of hype in science journalism. and one of them can be found in the humble, and little-known press release. We're talking with Chris Chambers about doing science about science journalism, and where the hype creeps in. Related links: The association between exaggeration in health related science news and academic press releases: retrospective observational study Claims of causality in health news: a randomised trial This...