US Physicians' Reactions To ACA Implementation, 2012-17

Physician Trust in the News Media and Attitudes toward COVID-19

CONTEXT

Previous research has established the importance of primary care physicians in communicating public health directives. The implicit assumption is that, because of their expertise, doctors provide accurate and up-to-date information to their patients independent of partisan affiliation or media trust.

METHODS

The authors conducted an online survey of 625 primary care physicians and used the results to test (1) whether physician trust in media outlets is consistent with their political partisanship, and (2) whether trust in media outlets influences (a) personal concern that someone in their family will get sick, (b) perceptions about the seriousness of the pandemic as portrayed in the media, and (c) trust in federal government agencies and scientists.

FINDINGS

Physicians are better positioned to critically evaluate health-related news, but they are subject to the same biases that influence public opinion. Physicians' partisan commitments influence media trust, and media trust influences concern that a family member will get sick, perceptions regarding the seriousness of the pandemic, and trust in federal government agencies and scientists.

CONCLUSIONS

Physician trust in specific media outlets shapes their understanding of the pandemic, and-to the extent that they trust conservative media outlets-it may limit their effectiveness as health policy messengers.

Responsibilities, Strategies, and Practice Factors in Clinical Cost Conversations: a US Physician Survey

BACKGROUND

Physicians play a key role in mitigating and managing costs in healthcare which are rising.

OBJECTIVE

Conduct a cross-sectional survey in 2017, comparing results to a 2012 survey to understand US physicians' evolving attitudes and strategies concerning healthcare costs.

PARTICIPANTS

Random sample of 1200 US physicians from the AMA Masterfile.

MEASURES

Physician views on responsibility for costs of care, enthusiasm for cost-saving strategies, cost-consciousness scale, and practice strategies on addressing cost.

KEY RESULTS

Among 1200 physicians surveyed in 2017, 489 responded (41%). In 2017, slightly more physicians reported that physicians have a major responsibility for addressing healthcare costs (32% vs. 27%, p = 0.03). In 2017, more physicians attributed "major responsibility" for addressing healthcare costs to pharmaceutical companies (68% vs. 56%, p < 0.001) and hospital and health systems (63% vs. 56%%, p = 0.008) in contrast to 2012. Fewer respondents in 2017 attributed major responsibility for addressing costs to trial lawyers (53% vs. 59%, p = 0.007) and patients (42% vs. 52%, p < 0.0001) as compared to 2012. Physician enthusiasm for patient-focused cost-containment strategies like high deductible health plans and higher co-pays (62% vs. 42%, p < 0.0001 and 62% vs. 39%, p < 0.0001, not enthusiastic, respectively) declined. Physicians reported that when they discussed cost, it resulted in a change in disease management 56% of the time. Cost-consciousness within surveyed physicians had not changed meaningfully in 2017 since 2012 (31.7 vs. 31.2). Most physicians continued to agree that decision support tools showing costs would be helpful in their practice (> 70%). After adjusting for specialty, political affiliation, practice setting, age, and gender, only democratic/independent affiliation remained a significant predictor of cost-consciousness.

CONCLUSIONS AND RELEVANCE

US physicians increasingly attribute responsibility for rising healthcare costs to organizations and express less enthusiasm for strategies that increase patient out-of-pocket cost. Interventions that focus on physician knowledge and communication strategies regarding cost of care may be helpful.