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The Cost-Effectiveness of Family Physicians – Cost-Consciousness

May 19, 2013

I will now embark on a series of posts highlighting some of the key findings of our study on how family physicians report they deliver cost-effective care.

One of our most basic findings was that family physicians felt that considering cost was one of the complexities that were just part of their medical decision making processes. Out of the 38 family physicians we interviewed, none gave us any pushback on the premise that family physicians commonly provide lower cost care than the ologists (and of course, we didn’t use that word in our study).

But just as quickly as the FPs gave examples of how they provided cost-effective care, they quickly stated that they do not do so at the risk or expense of their patients’ health. They felt they delivered equivalent or better care at a lower cost.

Examples included saving outrageous facility fees, such as giving dehydrated nauseous patients IV fluid and medicines in the office, thus saving the patient ridiculous ER charges. Stories were told of tests that were foregone or more effective treatments that were attempted first, just because the FP knew the patient and had the patience to have a thorough conversation and ask lots of questions.

I suspect most FPs could even be more cost-effective in their care than they currently are. I’m sure there is waste in most FPs offices. However, for a country with exorbitantly expensive healthcare to find a way out of the enormous debt hole it has dug for itself, being led by a cadre of physicians who actually care and worry about the cost of healthcare, and its impact on immediate patient/family needs and the future implications of mounting debt, would be a great place to start.

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2 Responses to The Cost-Effectiveness of Family Physicians – Cost-Consciousness

  1. Robert Watkins on May 20, 2013 at 12:14 pm

    Excellent articles. This appropriate use of resources has always been one of the core strengths of family medicine, which is why so many of us see red when the AAFP tells us that high quality, efficient care can only be delivered within the expensive, bureaucratic PCMH model.

    Question: what are the ethical responsibilities of the physician when he/she realizes that every dollar in savings goes directly to the executives and shareholders of for-profit insurers?

    • Richard Young MD on May 21, 2013 at 10:31 pm

      Yeah, I hope this article gives some of the PCMH advocates pause to re-think some of its assumptions and rules.

      As for the for-profit insurers, I’m not sure what physicians by themselves can do about it. I hope that large employers will band together someday and create their own non-profit insurance collaboratives, and save the profit margin for themselves. But they have to be willing to push back against the excesses of the healthcare industry.

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