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'Cowboy' doctors could be a half-a-trillion-dollar American problem

By WBUR  
   August 06, 2014

When Dartmouth economics professor Jonathan Skinner was speaking recently at the University of Texas about the "cowboy doctor" problem, an audience member objected: "You have a problem with cowboys?" Well, actually, we all have a problem with cowboys — when they're doctors. Including the Texans. New research written up in a National Bureau of Economic Research paper finds that "cowboy" doctors — who deviate from professional guidelines, often providing more aggressive care than is recommended — are responsible for a surprisingly big portion of America's skyrocketing health costs. The paper concludes that "36 percent of end-of-life spending, and 17 percent of U.S. health care spending, are associated with physician beliefs unsupported by clinical evidence."

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