The Journal of the American Medical Association published a study surveying 2556 physicians regarding controlling health spending. (JAMA Article) In terms of who has responsibility for cost control, doctors think the major responsibility lies with trial lawyers (60%); insurers (59%), hospitals (56%), drug and device manufacturers (56%) patients (52%), but a much smaller number feel that doctors themselves have a major responsibility 36%. In terms of strategies to control costs, physicians are most enthusiastic about quality oriented methods, like improving care coordination and getting more evidence-based data on treatments and diagnostics and less enthusiastic about changing reimbursement or having more patient cost-sharing. While doctors say they are aware of costs, most are resistant to considering costs, unless the patient is paying it. Things that inhibit a cost-consciousness include malpractice fears and patient demands. It has been pointed out a number of times that physicians are the cornerstone of any effort to affect health spending, because almost everything in the system requires a doctor’s order or prescription. A number of doctors seem to want to evade that fundamental responsibility, according to the survey results. Now it is fair to suggest that it is hard for physicians to be a cost control focus, because they are also supposed to be advocates for patients and do what they think is in the best interest of patients; and because they don’t usually have all the price information necessary to help make cost judgments. But physicians do need to accept that their actions are the primary determinants of utilization and spending and they need to take seriously the obligation to have a cost-conscious perspective that they discuss with patients.
Physician Views on Cost Control
By Kevin RocheAugust 1, 2013Commentary
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About this Blog
The Healthy Skeptic is a website about the health care system, and is written by Kevin Roche, who has many years of experience working in the health industry. Mr. Roche is available to assist health care companies through consulting arrangements through Roche Consulting, LLC and may be reached at [email protected].
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