Cost Knowledge Affects Doctors

Doctors who are aware of the costs of routine medical tests order fewer of them, researchers said last week. A study of physicians at a large Indiana medical clinic found that when the costs of various diagnostic tests were shown on a computer system they used, the number of tests they asked for declined by 15%.

But when the costs were no longer shown, the doctors went back to ordering virtually the same number of tests they had requested before they saw the computerized display, researchers at Indiana University found.

“It seems there is a whole lot that doctors do that is just mechanical and the numbers don’t sink in,” said study co-author Dr. Clement McDonald, who also is on the staff of the Regenstrief Institute for Health Care in Indianapolis, where the research took place.

During a 26-week period, 59 doctors used a computer system which showed the cost of every test they ordered, while a comparison group of 62 physicians saw no such display. The doctors who were aware of costs asked for fewer tests, which meant an average saving of $7 per patient visit, the researchers said in the New England Journal of Medicine.