Physicians May Not Have a Strong Understanding of Medical Costs

Primary care physicians thought the Choosing Wisely campaign helped reduce costs but few had a good understanding of costs for tests and procedures.

A recent study suggests that although physicians feel they have a responsibility to control costs, few have a firm grasp of the costs for tests and procedures.

A campaign called Choosing Wisely was created by the American Board of Internal Medicine Foundation to help physicians identify low-value services that do not offer much benefit to patients.

The study, published in the American Journal of Managed Care, tested physicians’ awareness of the initiative. Researchers created the Survey on Overuse and Knowledge of Choosing Wisely for physicians at Atrius Health.

Researchers discovered that only one-third of the respondents thought it was unfair to have physicians consider costs while being concerned with the patient’s welfare. One-third of respondents said they try not to consider costs and another third said they are too busy to worry about costs.

Approximately 92.2% of physicians reported they had the ability to control costs, yet 36.9% said they had a good grasp on the costs of tests and procedures.

Researchers also found that primary care physicians had greater awareness of the campaign than medical specialists and surgical specialists. Approximately 75.1% of primary care physicians felt that Choosing Wisely helped reduce the number of unnecessary tests compared with 64.4% of medical specialists and 54% of surgical specialists, according to the study.

Approximately 68.3% of primary care physicians surveyed they felt increased pressure to order tests and procedures and felt more pressure to refer patients to other consultants compared with medical and surgical specialists.

Surgical specialists were the most concerned with malpractice.

"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," concluded lead author Carrie Colla PhD. "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."