Most physicians do not understand medical costs, study finds

Most physicians agree they have a responsibility to control costs, but more than a third don't know how much tests and procedures cost, and about one in three physicians say they do not consider costs while making medical decisions, according to a recent study from The Dartmouth Institute for Health Policy and Clinical Practice. 

Published in the American Journal of Managed Care, the study gauged physicians' attitudes toward costs while also investigating awareness and understanding of an American Board of Internal Medicine campaign called "Choosing Wisely." The 4-year-old campaign was launched to help physicians identify and avoid healthcare services that give patients little benefit for their time and money. 

The researchers found that while 92 percent of physicians agreed they had a responsibility to control costs, only about 37 percent said they had a firm grasp of how much tests and procedures should cost. They also found about one-third third of physicians try not to think about costs while making medical decisions and one-third say they are too busy to worry about costs. They found a similar portion of respondents felt it was unfair to ask physicians to juggle both costs and patient wellbeing. Additionally, more than half of respondents felt pressure from patients to order tests and procedures, according to the report.

Researchers found primary care physicians were more likely to be aware of the Choosing Wisely campaign than medical or surgical specialists, and primary care physicians were also more likely to agree the campaign gave them the tools or information they needed to reduce unnecessary tests and procedures.

"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," lead author Carrier Colla, PhD, said in a statement. "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."

One limitation of the study was it only surveyed physicians at Atrius Health, a nonprofit independent multi-specialty medical group with physicians in locations across Massachusetts. It is the largest ambulatory care provider in the state.


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