Family medicine residents remain unaware of hospital charges for diagnostic testing

The Accreditation Council for Graduate Medical Education (ACGME) has mandated that resident training programs incorporate instruction on the economic reality of health care. Studies over the past 15 years have demonstrated that resident physicians, as well as physicians in practice, are unaware of the charges associated with commonly ordered diagnostic tests. The last study to document family medicine residents' knowledge of the hospital charges associated with diagnostic studies was published over 10 years ago. With increasing emphasis on cost containment in the past decade, we attempted to determine if any change over time had occurred in family medicine residents' knowledge of the charges associated with commonly ordered diagnostic studies.

Sixteen common laboratory and radiology tests were surveyed and distributed to 30 resident physicians at a community-based, family medicine residency program. Estimates within 25% of the actual charges were considered correct. These results were then compared to prior similar research. Correlation between years of completed training and percentage of correct estimates was also assessed.

A total of 26 of 30 surveys (87%) were completed and compared to actual charges. Only 81 (19%) of 416 estimates were within 25% of actual charges. No improvement was noted with advanced years of training. Compared to previous work, this study does not show gains in cost awareness among family medicine residents.

Family medicine residents remain largely unaware of the hospital charges associated with diagnostic studies despite increasing emphasis on cost containment. These results will hopefully expose the persistent lack of awareness of the costs associated with ordered radiology and laboratory studies.