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Most Physicians Blame Others for Rising Healthcare Costs

Cheryl Clark, for HealthLeaders Media, July 25, 2013

"On one hand, the majority of physicians were very willing to say, 'I need to go to go to bat for my patients even when it's expensive.' But at the same time, a majority also endorsed the idea—they were perfectly comfortable with—having limits on insurance coverage for marginally beneficial therapies."

But on reflection, Tilburt says, "we don't think that's contradictory to doing the best for our patients. Doing the best for patients often means starting with good, sound, tried-and-true old therapies and moving to more fancy bells and whistles down the road."

The survey revealed some other significant findings about physician attitudes as well.

Eighty-five percent of responders said they "should sometimes deny beneficial but costly services to certain patients because resources should go to other patients that need them more."

Nearly half (42%) strongly agreed with the statement "Doctors need to take a more prominent role in limiting use of unnecessary tests," and 47% moderately agreed with that statement.

Asked their views on the statement, "It is unfair to ask physicians to be cost-conscious and still keep the welfare of their patients foremost in their minds," 14% strongly agreed and 28% moderately agreed, while 58% moderately or strongly disagreed.

In an accompanying editorial, Ezekiel Emanuel, MD, and Andrew Steinmetz, BA, of the Department of Medical Ethics and Health Policy of the Wharton School at the University of Pennsylvania, wrote that the Tilburt survey results "are somewhat discouraging" because "they suggest that physicians do not yet have that 'all-hands-on-deck' mentality this historical moment demands."

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4 comments on "Most Physicians Blame Others for Rising Healthcare Costs"


W. Rhea (7/31/2013 at 10:36 AM)
Why should the cost of a course treatment using an older but excellent antibiotic have recently gone from +/- $8 to +/- $80? Are we looking at price gouging here. The same applie to many other areas in the medical field.

Matt Wynia (7/29/2013 at 2:16 PM)
There is a mistake in your report on this study. In fact, 85% of respondents DISAGREED with the statement that they "should sometimes deny beneficial but costly services to certain patients because resources should go to other patients that need them more."

Thomas Bladek MD (7/25/2013 at 3:58 PM)
I felt a need to respond to the distorted perception non-health care providers have for our current healthcare system. Their time is spent talking and writing about their perceptions. They are not in the offices, clinics, or hospitals on a daily basis caring for patients and seeing what clinical medical practice is really about. COSTS: I entered practice in 1987. The group I joined consisted of 10 physicians. We had a billing service through a local accounting firm. The person doing our billing was employed part-time, and she provided billing services for two other similar sized practices as well. Again, she processed claims "PART-TIME" for three practices. We submitted an index sized card with patient demographics, and charges for our profession fee. We billed @ 6,000 procedures/year, worked a 40 hour week, and our income held steady as it had been for the previous 10 years. In 1990, HMO penetration increased in Connecticut. The paperwork became more complex and burdensome. We asked the person doing our "part-time" billing to join our practice, and set up a billing office for us. She accepted, and hoped she would have enough work. Today, our billing office consists of: ? one (1) Business Manager to help negotiate/ renegotiate Managed Care Contracts, and ensure compliance with all healthcare mandates and regulations. ? one (1) Office Manager, ? five (5) billing and collections personnel, ? three (3) certified professional coders (two with R.N. degrees); ? one (1) coder to review outgoing codes to be sure we are in compliance with billing practices, and ? five (5) part-time office staff members. ? We employ an accountant, and a contract attorney pat-time. ? We have an IT professional to maintain and [INVALID] the $150,000 we spend in hardware every three years, a contract with a software vendor to [INVALID] our billing software annually. In 2008, we were a 12 physician practice. We billed @ 15,000 procedures and worked a 60 plus hour week. In 2008, each physician made 40% less than we did in 1987. Why ? The "perception", from a physician perspective, is "new" industries were created in hopes of capturing the healthcare dollar. Greed fueled the fire. It started with the HMO's. The number of individuals employed and the massive building complexes the HMO's inhabit make a large city hospital look like an inner city clinic. The HMO's effectively convinced the media and the public their mission was, "to contain rising healthcare costs". Private physician groups responded by increasing their staff in order to "submit a bill". Remember, I did not say "take care of patient's" or "get paid for service's rendered", rather, "to submit a bill". How many "consultants" justify their positions in society today on the backs of the healthcare dollar. Having trained for 9 years (after graduating college) to effectively care for the patient, I am offended when articulate non-healthcare providers attempt to brainwash the masses into believing the physician is overpaid and responsible for the "healthcare crisis".