MDs on Controlling Health Care Costs

Although physicians’ decisions play a key role in overall health care spending, they mostly believe that other groups as having a major responsibility to reduce costs, according to a study in JAMA.

In “Views of U.S. Physicians About Controlling Health Care Costs,” Jon C. Tilburt, MD, MPH, of the Mayo Clinic in Rochester, Minn., and colleagues surveyed physicians to assess their views regarding controlling health care costs.

“U.S. physicians’ opinions about their role in containing health care costs are complex,” the authors wrote. “In this survey, we found that they express considerable enthusiasm for several proposed cost-containment strategies that aim to enhance or promote high-quality care such as improved continuity of care.”

According to the authors, physicians showed considerably less enthusiasm for more substantial reforms. Medicare pay cuts are unpopular across the board and physicians are against eliminating fee-for-service reimbursement.

The study shows that physicians were more likely to identify insurers, lawyers, hospitals and other groups as having the majority of responsibility to cut health care costs. Although, 89% did say that “doctors need to take a more prominent role in limiting use of unnecessary tests.”

Only 36% reported that they think practicing physicians have a “major responsibility” for reducing health care costs. Most respondents believed that trial lawyers (60%), health insurance companies (59%) and patients (52%) bear the brunt of the responsibility.

In an accompanying editorial, Ezekiel J. Emanuel, MD, PhD, and Andrew Steinmetz, BA, of the University of Pennsylvania, Philadelphia, found the survey’s results “discouraging.”

“The findings suggest that physicians do not yet have that ‘all-hands-on-deck’ mentality this historical moment demands,” they wrote. “Indeed, the survey of 2,556 physicians suggests that in the face of this new and uncertain moment in the reform of the health care system, physicians are lapsing into the well-known, cautious instinctual approaches humans adopt whenever confronted by uncertainty: blame others and persevere with ‘business as usual.’”