07 Jan Primary Care Physicians Find It Difficult To Refuse Patient Requests For Unnecessary Medical Care
Dr. Sapna Kaul
MedicalResearch.com Interview with:
Sapna Kaul, Ph.D
Huntsman Cancer Institute
2000 Circle of Hope
Salt Lake City, UT 84112
Medical Research: What is the background for this study? What are the main findings?
Dr. Kaul: The United States has the highest healthcare expenditures in the world, and close to one-third of these expenditures are believed to be unnecessary. One potential reason for these unnecessary expenditures is that patients may ask for medical services that are unnecessary. At the same time, primary care physicians (PCP) could find it difficult to refuse to prescribe unnecessary medical services as they may worry that it may compromise patient satisfaction. Also, there is a shortage of primary care workforce in the U.S. and PCPs may have insufficient time to effectively address patient requests.
We investigated 2 types of unnecessary medical practices initiated by patient requests:
(1) providing unnecessary specialty referrals, and
(2) prescribing brand-name drugs when generic alternatives were available.
To explore these practices, we used data on 840 U.S. PCPs from a national survey of physicians conducted in 2009. Over 50% of primary care physicians reported providing unnecessary specialty referrals and 39% prescribed brand-name drugs at patient requests. Several provider and organizational factors, such as physician specialty and solo/2-person practice, were related to reporting unnecessary practices.
Medical Research: What should clinicians and patients take away from your report?
Dr. Kaul: Patients and physicians need to openly communicate about medical services and the necessity to reduce the provision of low-value care. The ABIM’s Choosing Wisely initiative is a great example here. It is aimed at bringing stakeholders, including the physicians and patients, together to question the provision of commonly used medical treatments and procedures.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Kaul: We need more up-to-date studies to evaluate the impact of recent policy changes such as the Affordable Care Act on unnecessary medical practices and that examine these issues with clinical data. In addition, future studies should evaluate the exact impact of unnecessary specialty referrals on healthcare expenditures in the U.S.
Citation:
Physician Response to Patient Request for Unnecessary Care
Am J Manag Care. 2015;21(11):823-832
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Sapna Kaul, Ph.D (2016). Primary Care Physicians Find It Difficult To Refuse Patient Requests For Unnecessary Medical Care MedicalResearch.com
Last Updated on January 7, 2016 by Marie Benz MD FAAD