U.S. Medical Student Attitudes Toward and Experiences With Cost-Conscious Care

Andrea N. Leep Hunderfund, MD, MHPE, Liselotte N. Dyrbye, MD, MHPE, Stephanie R. Starr, MD, Jay Mandrekar, PhD, James M. Naessens, ScD, Jon C. Tilburt, MD, MPH, Paul George, MD, MHPE, Elizabeth G. Baxley, MD, Jed D. Gonzalo, MD, MSc, Christopher Moriates, MD, Susan D. Goold, MD, Patricia A. Carney, PhD, Bonnie M. Miller, MD, Sara J. Grethlein, MD, Tonya L. Fancher, MD, MPH, and Darcy A. Reed, MD, MPH

Physicians have a professional obligation to provide effective care through prudent stewardship of public and private health care resources. However, up to 30% of health care spending in the United States is wasted, and a major source of waste is unnecessary health care services. Overuse of tests and procedures increases costs and reduces quality of care by exposing patients to unnecessary risk, burdening them with out-of-pocket expenses, and displacing or delaying care they actually need.

Purpose

To examine medical student attitudes toward cost-conscious care and whether regional health care intensity is associated with reported exposure to physician role-modeling behaviors related to cost-conscious care.

Conclusions

Medical students endorse barriers to costconscious care and encounter conflicting role-modeling behaviors, which are related to regional health care intensity. Enhancing role modeling in the learning environment may help prepare future physicians to address health care costs.