title: Shared decision-making as a cost-containment strategy: US physician reactions from a cross-sectional survey.
abstract: OBJECTIVE
  To assess US physicians' attitudes towards using shared decision-making (SDM) to achieve cost containment.
  
  
  METHODS
  Cross-sectional mailed survey.
  
  
  METHODS
  US medical practice.
  
  
  METHODS
  3897 physicians were randomly selected from the AMA Physician Masterfile. Of these, 2556 completed the survey.
  
  
  METHODS
  Level of enthusiasm for "Promoting better conversations with patients as a means of lowering healthcare costs"; degree of agreement with "Decision support tools that show costs would be helpful in my practice" and agreement with "should promoting SDM be legislated to control overall healthcare costs".
  
  
  RESULTS
  Of 2556 respondents (response rate (RR) 65%), two-thirds (67%) were 'very enthusiastic' about promoting SDM as a means of reducing healthcare costs. Most (70%) agreed decision support tools that show costs would be helpful in their practice, but only 24% agreed with legislating SDM to control costs. Compared with physicians with billing-only compensation, respondents with salary compensation were more likely to strongly agree that decision support tools showing costs would be helpful (OR 1.4; 95% CI 1.1 to 1.7). Primary care physicians (vs surgeons, OR 1.4; 95% CI 1.0 to 1.6) expressed more enthusiasm for SDM being legislated as a means to address healthcare costs.
  
  
  CONCLUSIONS
  Most US physicians express enthusiasm about using SDM to help contain costs. They believe decision support tools that show costs would be useful. Few agree that SDM should be legislated as a means to control healthcare costs.
authors.affiliation: Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Jon C
authors.initials: JC
authors.lastname: Tilburt
authors.forename: Matthew K
authors.initials: MK
authors.lastname: Wynia
authors.forename: Victor M
authors.initials: VM
authors.lastname: Montori
authors.forename: Bjorg
authors.initials: B
authors.lastname: Thorsteinsdottir
authors.forename: Jason S
authors.initials: JS
authors.lastname: Egginton
authors.forename: Robert D
authors.initials: RD
authors.lastname: Sheeler
authors.forename: Mark
authors.initials: M
authors.lastname: Liebow
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Humeniuk
authors.forename: Susan Dorr
authors.initials: SD
authors.lastname: Goold
mesh_terms: D001291:Attitude of Health Personnel; D003363:Cost Control; D003430:Cross-Sectional Studies; D003657:Decision Making; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010820:Physicians; D011795:Surveys and Questionnaires; D014481:United States
keywords: Medical Ethics