Primary Care Clinicians' Perspectives on Reducing Low-Value Care in an Integrated Delivery System

Area of Science:

• Health Services Research
• Medical Economics
• Clinical Practice Management

Background:

• Understanding clinician perceptions of low-value care is crucial for cost containment.
• Clinicians with capitated salaries' views on unnecessary medical tests and procedures were previously unknown.

Purpose of the Study:

• To explore clinicians' perceptions of low-value care.
• To identify barriers to reducing low-value care.
• To assess awareness of the Choosing Wisely campaign and response to peer-comparison data.

Main Methods:

• A 2013 cross-sectional electronic survey was administered to 304 salaried primary care physicians and physician assistants.
• The survey assessed attitudes, awareness, and barriers related to low-value care strategies.
• A 62% response rate (189 clinicians) was achieved.

Main Results:

• Over 90% of clinicians acknowledged the importance of cost and fairness in cost-consciousness.
• Most found peer-comparison reports useful for practice pattern analysis and discussion.
• While comfortable discussing low-value care, 80% would order tests if patients insisted; key barriers included time, patient preferences, and community standards.

Conclusions:

• Salaried clinicians are aware of healthcare costs and desire to manage resources effectively.
• Evidence-based initiatives, such as the Choosing Wisely campaign, can encourage clinicians to be conscientious stewards of healthcare resources.