Blog | Friday, November 9, 2012

QD: News Every Day--New physicians spend more than experienced ones


Physicians who are new to practice have higher cost profiles than more experienced physicians, according to a new study.

Researchers analyzed physician cost profiles from health care plans in Massachusetts to see if any physician characteristics were associated with higher costs. Data from 12,116 physicians were included. A total of 15.9% of the sample had fewer than 10 years of experience, while 7.5% had more than 40 years of experience. Approximately 24% of the included physicians practiced internal medicine.

Overall, costs were 13.2%, 10.0%, 6.5%, and 2.5% higher in physicians with fewer than 10 years, 10 to 19 years, 20 to 29 years, and 30 to 39 years of experience compared with those who had 40 years of experience or more. Other characteristics, such as malpractice claims, group size, or board certification, did not appear to be associated with costs. The study appears in the November Health Affairs.

The authors noted that they did not consider quality of care, examined physicians in a single state, and could not address causality, among other limitations. However, they concluded that physicians with higher cost profiles could suffer future negative effects, such as reduced Medicare payments and exclusion from high-value networks. The authors pointed out that physicians' costs might drop as they spend more time in practice but also raised the possibility of a cohort effect, which would mean that costs in these groups of physicians would remain high over time.

"We cannot fully explain the mechanism by which more-experienced physicians have lower costs," the authors wrote, "but our results suggest that the more costly practice style of newly trained physicians may be a driver of rising health care costs overall." If future research confirms their results, they said, the mechanisms behind these differences in cost should be studied further.