Doogie Howser Would Beat Marcus Welby in Patient Care Spending

Doctors with the least experience spend significantly more money treating patients, according to a RAND study. Recently trained doctors may be more familiar with expensive new treatments. Also, their uncertainty and lack of experience may translate into more-aggressive medical care. Less-experienced doctors may also attract patients with problems that are harder to address. As newer doctors gain more experience and have longer relationships with patients, their practice patterns may become less costly. But, it is also possible that the cost differences remain throughout their careers.

Researchers looked at commercial health plan claims for more than 1 million Massachusetts residents from 2004 and 2005 to construct cost profiles for more than 12,000 doctors in the state. Doctors with less than 10 years of experience had 13.2% higher costs than doctors with 40 or more years of experience. Doctors with 10 to 19 years of experience had 10% higher costs; those with 20 to 29 years of experience had 6.5% higher costs; and those with 30 to 39 years of experience had 2.5% higher costs. Factors that did not affect costs include whether the doctor had a malpractice claim or disciplinary action, whether a doctor was board certified, or the size of the medical practice.

The cost difference does not suggest that less-experienced doctors provide better medical care. Previous research has found only a weak relationship between quality and spending. Researchers say that post-graduate training programs and specialty medical boards need to educate doctors about their responsibility to be good stewards of health care resources.

Researchers also say that the findings could have significant implications for less-experienced doctors who might be excluded from contracting networks or face lower payments as both private insurers and government programs look to reward health care providers who deliver quality care at a lower cost. For more information, visit http://www.rand.org/newsletters.html

Last Updated 10/4/2017

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