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Inexperienced Doctors Are More Expensive
How can we reduce healthcare costs? To some extent, the soaring cost of health insurance reflects the rising cost of medical treatment. Reducing the use of screening is one option for reducing medical costs that is being explored; finding less expensive drug regimens is another. Doctors are on the front lines of medical cost containment. So the recent finding that younger, less experienced doctors “cost” us more money than older, more experienced ones may offer some clues to what it takes to cut medical expenses.
Researchers at the nonprofit research institute, RAND, looked at 1 million healthcare claims from Massachusetts residents, and focused on 600 “episodes of care,” to determine if there was a relationship between the age of the doctor who treated the health problem and the cost of the care. They found that the “cost profiles” of doctors with less than 10 years of experience was 13% higher than doctors with over 40 years of experience. This relationship between reduced cost and age of the doctor increased incrementally over the years: Doctors with 10-19 years’ experience had cost profiles 10% higher than doctors practicing 40 years; those with 20-29 years were associated with a 6.5% increase in cost; and doctors with 30-39 years had a 2.5% higher cost.
The researchers found no connection between cost and other variables like malpractice, board certification, or the size of the practice in which the doctor worked. The study did not attempt to look at the quality of care.
"These findings are provocative,” said study author Ateev Mehrotra in a news release, “but they warrant further examination and need to be affirmed by additional studies. However, it is possible that one driver of health care costs is that newly trained physicians practice a more-costly style of medicine."
The study did not address why younger doctors provide more costly care. It could be that younger, more inexperienced doctors are ordering more tests before arriving at a diagnosis. Or it could be that younger doctors are more familiar with newer technologies that cost more money to carry out.
It's possible that the higher cost profiles of younger doctors will decrease over the years as they gain experience and home in on diagnoses more quickly. Alternatively, their cost could remain high as newer, more expensive technologies come along. "Our findings cannot be considered final, but they do underscore the need to better understand physician practice patterns and what influences that behavior," Mehrotra said.
The authors also urge medical boards and training programs to teach doctors how to keep costs down while still practicing the best medicine they can. Finding the balance between cost and care is not simple, and it will surely be an ongoing discussion, particularly as healthcare in the US continues to evolve.
The study was carried out by researchers at the University of Pittsburgh, and published in the journal, Health Affairs.
November 7, 2012