A win for grey hairs! Experienced docs save money
© 2012 Roy Benaroch, MD
One thing’s clear: we’re spending gobs of money on health care, and we can’t afford to keep doing it.
A provocative RAND Corp study published this month looked at Massachusetts health care spending from 2004-2005, examining the claims data from 1 million residents and 12,000 doctors. They found that the more experienced the doctor, the less health care dollars were spent to diagnose and treat the same health conditions. The differences became larger as more years of experience accumulated. Overall, physicians with 40 or more years of experience had about 13% less costs than those fresh out of residency.
Costs were not associated with other factors—it didn’t matter, for instance, whether the doctors had had a malpractice claim, or were board certified, or whether they practiced in a large or small group. This study didn’t look at outcomes, so it wasn’t designed to see if the increased costs associated with less experienced physicians could mean that there was better health care overall. But other studies have clearly refuted that. Increased costs do not mean better outcomes or better health.
So why does more experience seem to lead to less spending? The authors have some ideas:
- Younger docs may rely more on the newest, most-expensive technologies. That would be OK, if these devices improved overall health—but there is no evidence that this is true.
- Less-experienced docs may be less confident, so might order more tests and procedures.
- Older docs may have patients who trust them more, who might then not push for the latest drugs and tests.
Is 13% a big difference? Considering overall health care expenditures of $2.5 trillion per year in the USA, that 13% is about 325 billion dollars. That could certainly buy a few bottles of Grecian Formula or Clairol for those experienced docs who’ve learned to spend less and still provide good care. And also provide health care for just about every uninsured American – with about 200 billion left over for a tablet computer for every single human on the planet.
(You think I’m kidding? This November, 2012 study puts the cost of healthcare for uninsured Americans at $125 billion per year, leaving 200 billion to spare from the overall 13% cost savings. There are about 6 billion people on the planet, so that 200 billion works out to $30 per person. There are inexpensive computers in development for $25-50 each. The costs of health care are truly staggering, and it’s easy to lose perspective on just how much money we are wasting. Ironically, it’s not even our money—it’s the money our children and grandchildren haven’t even earned yet. Ha ha, suckers, that’s why we don’t let you vote!)
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