While a recent survey showed that about one in six U.S. doctors believe they bear some responsibility for holding down healthcare costs, they think the burden falls more heavily on trial lawyers, health insurers, hospitals, pharmaceutical companies, medical device makers and even patients.
The survey by Mayo Clinic researchers, published today 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.
"What physicians are trying to tell us is that they don't see themselves as necessarily any more responsible for healthcare costs than all of those stakeholders," said lead author Jon Tilburt, M.D., an associate professor at the Mayo Clinic, according to the Kaiser Health News Capsule blog. "They see themselves as a contributor, not a main contributor."
In other findings:
- 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."
- Only 7 percent were enthusiastic about eliminating fee-for-service payment models.
- 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.
"The findings suggest that physicians do not yet have that 'all-hands-on-deck' mentality this historical moment demands," the University of Pennsylvania's Ezekiel J. Emanuel, M.D., Ph.D., and Andrew Steinmetz wrote in an accompanying editorial, Medscape Today noted. "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."