When Physicians See Costs, They Act Like Consumers
Feldman is the lead author of a new online study published this week in JAMA Internal Medicine that found that when doctors are told the price of some diagnostic laboratory test as the tests are ordered, they respond like informed consumers and either order fewer tests or shop around for cheaper alternatives.
"One of the best ways to make sure we are doing the best by our patients is to order the tests that actually needs to be ordered for that patient and to remember that there is a cost to every test that we order," Feldman says.
The Johns Hopkins study identified 62 diagnostic blood tests frequently ordered for patients at The Johns Hopkins Hospital. Researchers divided the tests into two groups and made sure prices were attached to one group from November 2009 to May 2010 at the time doctors ordered the lab tests.
They left out the pricing information for the other group over the same time period. When the researchers compared ordering rates to a six-month period a year earlier when no costs were displayed, they found a nearly 9% reduction in tests when the cost was revealed as well as a 6% increase in tests when no price was given. The net charge reduction was more than $400,000 over six months.
Researchers were surprised to find that the biggest savings came when doctors changed ordering patterns for basic and relatively inexpensive tests that are ordered thousands of times, rather than from costlier tests.
"We thought if we were able to decrease these expensive tests we will make a difference," Feldman says. "It turns out that those expensive tests aren't ordered often enough that decreasing the number ordered by a good percentage… doesn't actually save money."
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