Few Doctors Consider Themselves as Drivers of Healthcare Costs

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A recent survey showed that only one in six U.S. doctors believe they bear some responsibility for holding down health care costs. According to the survey, as reported by FierceHealthcare, they think the burden falls more heavily on trial lawyers, health insurers, hospitals, pharmaceutical companies, medical device makers and even patients. Discussion of health care costs is an important topic on Policy and Medicine, something we have written about at length.

The survey by Mayo Clinic researchers, published in the Journal of the American Medical Association, found that only 36 percent of the 2,556 physicians responding to the survey thought practicing physicians had a “major responsibility” to reduce healthcare costs.

By contrast, 52 percent said patients bear a “major responsibility.” The biggest blame fell on trial lawyers, whom 60 percent of physician respondents said had a major responsibility to reduce costs, and health insurance companies, at 59 percent.

According to Kaiser Health News, the doctors were less enthusiastic about changing current payment models. Only 7 percent, for example, were very enthusiastic about eliminating the traditional fee-for-service payment system, while another 23 percent were somewhat enthusiastic. About a third of the physicians expressed enthusiasm for bundled payment systems.

Though about one in three doctors think they have major responsibility, the survey shows that doctors recognize they do have a role in addressing health care costs, said Dr. Jay Crosson, the American Medical Association’s vice president of professional satisfaction, care delivery and payment.

“These are all really good things, and sometimes people don’t recognize the positivity that exists in the physician community,” Crosson added.

As reported, other findings include:

  • Three out of four said they are aware of the costs of the tests and treatments they recommend.
  • Nine out of 10 agreed doctors need to be more involved in limiting unnecessary tests.
  • 85 percent disagreed with the idea of denying beneficial but costly services to some patients because other patients might need them more.
  • 75 percent were “very enthusiastic” about promoting continuity of care, while about half were very enthusiastic about expanding access to quality and safety data and limiting access to expensive treatments “with little net benefit.”
  • About six in 10 physicians were not enthusiastic about penalizing providers for avoidable hospital readmissions, and 65 percent felt the same way about bundled payments.

In an accompanying editorial, the University of Pennsylvania’s Ezekiel J. Emanuel, M.D., Ph.D., and Andrew Steinmetz, noted: “The findings suggest that physicians do not yet have that ‘all-hands-on-deck’ mentality this historical moment demands.”

“Physicians must commit themselves to act like the captain of the healthcare ship and take responsibility for leading the United States to a better healthcare system that provides higher-quality care at lower costs.”

 

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