Mehrotra says that the study is significant because previous studies on the relationship between practice patterns and physician experience are mixed. Several studies have found lower rates of diagnostic testing among more experienced physicians, but other studies have found the opposite relationship between experience and services, such as electrocardiograms, Mehrotra says.
"Although winners and losers are inevitable in any cost profiling effort, physicians with less experience are likely to be negatively affected by policies that use cost profiles unless they change their practice patterns," Mehrotra wrote.
He says that physician-training programs should focus more attention on cost-efficiencies. "Postgraduate training programs and specialty boards need to educate physicians on their responsibility to be good stewards of healthcare resources."
"It is conceivable that as they gain more experience these same physicians may develop less costly practice patterns," he adds. One of the ways they can do that is through multi-disciplinary approaches that many hospital systems are embarking on—true partnerships focusing on quality and efficiency, Mehrotra told me.
Like this week's elections, he adds, "winners and losers" are inevitable in any cost profiling effort. And, coordinated care is needed among young and older physicians because, for one thing, healthcare reform is well on its way, with Romney's vision of it being erased, gone with his defeat.