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Most Physicians Blame Others for Rising Healthcare Costs

Cheryl Clark, for HealthLeaders Media, July 25, 2013

Rather, it suggests "that in the face of this new and uncertain moment in the reform of the healthcare system, physicians are lapsing into the well-known, cautious instinctual approaches humans adopt whenever confronted by uncertainty: blame others and persevere with 'business as usual.' "

"Indeed," they continued, "only employers and physicians' professional societies were reported to bear less responsibility than the individual practitioner. This is a denial of responsibility… Can they really be both captain of the healthcare ship and cede responsibility for cost control to almost everyone else?"

Tilburt says that he thinks that as a society, "we're reaching a point where these kinds of 'I don't know (what it costs) responses aren't going to fly anymore. The belt tightening of the economy has everybody thinking about price and making everybody more price-sensitive.

That's tough, and gets into a muddy ethical area doctors call "dual-agency," in which the physician is called upon to look at both sides of the issue, from the patients perspective and society's.

"There will be a lot of questions on how to do this best. If we're going to expect physicians to uphold the best interests of patients, and at the same time do a lot of dirty work on behalf of society to keep costs down, we have to give doctors the vocabulary to do that with integrity."

However, he says, this doesn't have to undermine patient-centered nature of their obligations.  

"The profession and healthcare institutions are finally at the point where they are ready to say, 'Look, there's no reason why we can't put cost information in front of patients and doctors in a clinical interaction.' It's material information."


Cheryl Clark is senior quality editor and California correspondent for HealthLeaders Media. She is a member of the Association of Health Care Journalists.
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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".