Are primary care physicians ready to practice in a consumer-driven environment?
OBJECTIVE
To evaluate physicians' readiness to care for patients enrolled in consumer-directed health plans (CDHPs), which change the nature of cost sharing and medical decision making in primary care.


METHODS
Mailed cross-sectional survey of 1500 nationally representative primary care physicians.


METHODS
Physicians' knowledge of CDHP benefit design, readiness to advise patients about financial issues, and views regarding the role of quality-of-care information in patient decision making were assessed. Results were analyzed using descriptive statistics and multivariate models.


RESULTS
Five hundred twenty-eight of 1076 eligible physicians (49%) responded to the survey. Forty percent of physicians had CDHP enrollees in their practices. Forty-three percent of physicians reported low knowledge of CDHP cost sharing, and approximately one-third reported low knowledge of how medical savings accounts function. Overall, physicians with CDHP enrollees in their practices had higher knowledge than physicians without these patients; however, 1 in 4 of these providers reported low knowledge of CDHP cost sharing. More than two-thirds of all physicians were ready to advise patients on the costs of office visits, medications, and laboratory tests; approximately half or less were ready to advise on the costs of radiologic studies, specialist visits, and hospitalizations. Forty-eight percent were ready to discuss medical budgets with patients. Twenty-one percent of physicians thought that patients could trust quality-of-care information from government Web sites, and 8% thought that patients could trust quality-of-care information from insurance Web sites.


CONCLUSIONS
Many primary care physicians report low knowledge of CDHPs, limited readiness to advise patients on issues of cost and medical budgeting, and minimal trust in quality-of-care information.
Robert Wood Johnson Clinical Scholars Program, University of Pennsylvania, Philadelphia, PA 19104, USA. gmallya@mail.med.upenn.edu
Giridhar
G
Mallya
Craig Evan
CE
Pollack
Daniel
D
Polsky
D000368:Aged; D003430:Cross-Sectional Studies; D003657:Decision Making; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010358:Patient Participation / Q000191:economics*; D010821:Physicians, Family / Q000191:economics / Q000523:psychology / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care / Q000191:economics; D011795:Surveys and Questionnaires; D014481:United States