When it comes to controlling the country鈥檚 health care costs, doctors point their fingers at lawyers, insurance companies, drug makers and hospitals. But well over half acknowledge they have at least some responsibility as stewards of health care resources.
Based on their findings, 59 percent of doctors believed they have some responsibility in holding down听听health care costs. Only 36 percent thought they have a major role.
More than half of doctors, however, said each of five other groups carry 鈥渕ajor responsibility:鈥� trial lawyers, health insurance companies, pharmaceutical companies, hospitals and patients.
鈥淲hat physicians are trying to tell us is that they don鈥檛 see themselves as necessarily any more responsible for health care costs than all of those stakeholders,鈥� said Dr. Jon Tilburt, an associate professor at the Mayo Clinic and the study鈥檚 lead author. 鈥淭hey see themselves as a contributor, not a main contributor,鈥� he added.
When asked about options to reduce health care costs, most doctors viewed efforts to improve the quality and efficiency of care most favorably. For example, 98 percent are enthusiastic听about efforts to promote care coordination for people with chronic diseases. Doctors were also mostly in favor of improving conditions for evidence-based decisions, including efforts to prevent corporate influence of physicians鈥� decisions and promoting head-to-head trials of competing treatments.
They were less enthusiastic about changing current payment models. Only 7 percent, for example, were very enthusiastic about eliminating the traditional fee-for-service payment system, while another 23 percent were somewhat enthusiastic. About a third of the physicians expressed听enthusiasm for bundled payment systems.
Though about one in three doctors think they have major responsibility, the survey shows that doctors recognize they do have a role in addressing health care costs, said Dr. Jay Crosson, the American Medical Association鈥檚 vice president of professional satisfaction, care delivery and payment.
鈥淭hese are all really good things, and sometimes people don鈥檛 recognize the positivity that exists in the physician community,鈥� Crosson added.
Tilburt also听 said the results cast a positive light on doctors.
Close to 80 percent, for example, felt that they should be solely devoted to their patients鈥� best interests, regardless of cost. 鈥淭hey will choose taking care of the patients over eliminating health care costs,鈥� Tilburt said.
Only 16 percent of the doctors said they agreed that they 鈥渟hould sometimes deny beneficial, but costly services to certain patients because resources should go to other patients that need them more.鈥� At the same time, nearly one in nine of the doctors said they need to take 鈥渁 more prominent role鈥� in limiting unnecessary tests.
Tilburt says some doctors worry the health law听might have incentives that would prevent them from doing enough for patients. 鈥淚 don鈥檛 think that鈥檚 the intent of many of these reforms, but I think physicians are nervous and they need to be shown where are the win-win strategies that鈥檚 good for individual patients and for society,鈥� he said.
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