Physicians who choose more expensive medical test options believe, according to study results, that money saved by using a less expensive approach would go toward the profits and salaries of insurance companies and their executives and not to improved clinical services or reduced insurance premiums for patients.
"Health care inflation has reared its ugly head again. We thought we had it under control with managed care but we were wrong. It's back and rising quickly" and physician perceptions may be to blame, says Peter Ubel, M.D., senior author of the study, which will be published in the June issue of the American Journal of Managed Care. Ubel is associate professor of internal medicine at the University of Michigan Medical School and director of the U-M Health System's Program for Improving Health Care Decisions.
Ubel and a team of researchers from the University of Pennsylvania sent primary care physicians a series of scenarios presenting a choice between an effective but less expensive cancer screening or a more expensive and somewhat more effective alternative. Physicians also were asked who they thought would see the cost savings if they chose the less expensive option.
The questions included issues such as: Would you routinely choose flexible sigmoidoscopy or the more expensive colonoscopy to screen for colon cancer? Should a healthy 22-year-old woman with no history of cervical cancer receive a Pap smear every year or every three years? Should women with normal risk of breast cancer begin having mammograms at age 40 or 50?
Slightly more than half of the 865 physicians nationwide who responded chose the more expensive screening. Of that group, 77 percent said they felt any money saved through the o
Contact: Nicole Fawcett
University of Michigan Health System