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AJOB Primary Research.

Taking societal cost into clinical consideration: U.S. physicians’ views

Background: Recent campaigns (e.g., the American Board of Internal Medicine Foundation’s Choosing Wisely) reflect the increasing role that physicians are expected to have in stewarding health care resources. We examine whether physicians believe they should pay attention to societal costs or refuse requests for costly interventions with little chance of patient benefit. Methods: We conducted a secondary analysis of data from a 2010 national survey of 2016 U.S. physicians sampled from the AMA Physician Masterfile. Criterion measures were agreement or disagreement with two survey items related to costs of care. We also examined whether physicians’ practice and religious characteristics were associated with their responses. Results: The adjusted response rate was 62% (1156/1878). Forty-seven percent of physicians agreed that physicians “should not consider the societal cost of medical care when caring for individual patients,” whereas 69% agreed that physicians “should refuse requests from patients or their families for costly interventions that have little chance of benefitting the patient.” Physicians in specialties that care for patients at the end of life were more supportive of refusing such costly interventions. We did not find consistent associations between physicians’ religiosity and their responses to these items, though those least supportive of taking into account societal cost were disproportionately from Christian affiliations. Conclusion: Physicians were nearly evenly divided regarding whether they should help control societal costs when caring for individual patients, but a strong majority agreed that physicians should refuse costly interventions that have little chance of benefit.

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Volume 9, Issue 3
November 2018

Target Articles.

Parents’ attitudes toward consent and data sharing in biobanks: A multisite experimental survey Armand H. Matheny Antommaria, Kyle B. Brothers, John A. Myers, Yana B. Feygin, Sharon A. Aufox, Murray H. Brilliant, Pat Conway, Stephanie M. Fullerton, Nanibaa’ A. Garrison, Carol R. Horowitz, Gail P. Jarvik, Rongling Li, Evette J. Ludman, Catherine A. McCarty, Jennifer B. McCormick, Nathaniel D. Mercaldo, Melanie F. Myers, Saskia C. Sanderson, Martha J. Shrubsole, Jonathan S. Schildcrout, Janet L. Williams, Maureen E. Smith, Ellen Wright Clayton & Ingrid A. Holm
Reliance agreements and single IRB review of multisite research: Concerns of IRB members and staff Charles W. Lidz, Ekaterina Pivovarova, Paul Appelbaum, Deborah F. Stiles, Alexandra Murray & Robert L. Klitzman
Taking societal cost into clinical consideration: U.S. physicians’ views Alissa R. Stavig, Hyo Jung Tak, John D. Yoon & Farr A. Curlin
Freezing fertility or freezing false hope? A content analysis of social egg freezing in U.S. print media Lisa Campo-Engelstein, Rohia Aziz, Shilpa Darivemula, Jennifer Raffaele, Rajani Bhatia & Wendy M. Parker
Conflicts of interest policies for authors, peer reviewers, and editors of bioethics journals Zubin Master, Kelly Werner, Elise Smith, David B. Resnik & Bryn Williams-Jones