U.S. Physicians Not Supportive of Changes in Payment Models
Although docs agree on need to reduce costs, most don't want to eliminate fee-for-service approach
TUESDAY, July 23 (HealthDay News) -- U.S. physicians accept some responsibility for reducing health care costs in their practice, but most do not want to change payment models, according to research published in the July 24/31 issue of the Journal of the American Medical Association.
Jon C. Tilburt, M.D., M.P.H., of the Mayo Clinic in Rochester, Minn., and colleagues conducted a cross-sectional study by mail in 2012 involving 3,897 U.S. physicians who were randomly selected from the American Medical Association Masterfile; 2,556 physicians responded (65 percent). The survey examined physician attitudes toward health care costs and their perceived role in cost containment.
According to the researchers, physicians believe that "major responsibility" for reducing health care costs lies with trial lawyers (60 percent), health insurance companies (59 percent), hospitals and health systems (56 percent), pharmaceutical and medical device companies (56 percent), and patients (52 percent). Only 36 percent of participants responded that physicians have "major responsibility" for reducing costs. Most physicians claimed awareness of the costs of tests and treatments (76 percent) and agreed on adhering to clinical guidelines (79 percent), pursuing the best interests of the patient regardless of cost (78 percent), and recognizing the need for doctors to limit use of unnecessary tests (89 percent). A minority of physicians (7 percent) expressed support for eliminating fee-for-service payment models as an approach to reducing health care costs.
"Physician autonomy and leadership can only be affirmed if accompanied by acceptance of responsibility and accountability," write the authors of an accompanying editorial. "Unless physicians want to be marginalized -- unless they are willing to become just another deckhand -- they must accept and affirm that they are responsible for controlling health care costs."
Abstract (http://jama.jamanetwork.com/article.aspx?articleid=1719740#Abstract )Full Text (subscription or payment may be required) (http://jama.jamanetwork.com/article.aspx?articleid=1719740 )