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.
✅ Subscribe via Email
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].
Healthy Skeptic Podcast
This is an outstanding report on total global drug spending and trends, with projections out to 2025. It helps you understand this important area of health care, which does much...
June 1, 2021
MedPAC 2019 Report to Congress
June 18, 2019
Cano Health apparently cannot, as it declares bankruptcy due to too much debt. Building primary care centers to serve Medicare, Medicaid and commercial populations, which is Cano’s business, was hot...
February 6, 2024
Turquoise health raises a fresh $30 million in capital for its price transparency platform, as the market for funding health care companies isn’t quite dead yet.
January 24, 2024
I am co-f0under of a company that manages cell and gene therapy for health plans. Cell therapy has made a big difference for many cancer patients but like all new...
January 24, 2024
Access ACO Care Management Chronic Disease Comparative Effectiveness Consumer Directed Health Consumers Devices Disease Management Drugs EHRs Elder Care End-of-Life Care FDA Financings Genomics Government Health Care Costs Health Care Quality Health Care Reform Health Insurance Health Insurance Exchange HIT HomeCare Hospital Hospital Readmissions Legislation M&A Malpractice Meaningful Use Medicaid Medical Care Medicare Medicare Advantage Mobile Pay For Performance Pharmaceutical Physicians Providers Regulation Repealing Reform Telehealth Telemedicine Wellness and Prevention Workplace