
A new study of attitudes about health care costs reveals that an overwhelming majority of U.S. physicians feel a responsibility to address costs, but prioritize their obligations to patients' best interests over cost concerns. Results of the random survey of 2,500 U.S. physicians are published in this week's Journal of the American Medical Association (JAMA).
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"Physicians feel stuck in a difficult position," says lead author Jon Tilburt, M.D., Mayo Clinic's Biomedical Ethics Program and Center for the Science of Health Care Delivery. "Despite their sense of responsibility to address health care costs, physicians consistently express a commitment to the best interests of patients even when it is expensive. Given this finding, we recommend that cost-containment strategies aimed at physician behavior should focus on innovations that not only promote savings but also preserve physicians' commitment to individual patients."
Survey highlights include:
Researchers also assessed physicians' attitudes about strategies to constrain health care spending. Major findings include:
"We found that physicians' degree of enthusiasm for various cost-containment strategies was associated with practice setting and compensation structure," says Dr. Tilburt. "Salaried physicians and those in larger institutional practice settings reported a significantly higher degree of cost-consciousness compared to physicians whose compensation is based on billing and those in small or solo practices."
The study was funded by the Greenwall Foundation and the Mayo Clinic Program in Professionalism and Ethics. Co-authors include Matthew Wynia, M.D.; Robert Sheeler, M.D.; Bjorg Thorsteinsdottir, M.D.; Katherine M. James; Jason S. Egginton; Mark Liebow, M.D.; Samia Hurst, M.D.; Marion Danis, M.D.; and Susan Dorr Goold, M.D.
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