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Few Residency Programs Teach Cost-Conscious Medicine

Despite perceived role in limiting increasing health care costs, few residents know costs of tests

WEDNESDAY, Dec. 18, 2013 (HealthDay News) -- Few residency programs have a formal cost-conscious care curriculum, according to a research letter published online Dec. 16 in JAMA Internal Medicine.

Mitesh S. Patel, M.D., M.B.A., from the Philadelphia VA Medical Center, and colleagues assessed the state of cost-conscious care education among internal medicine residency programs in the United States. Residency program directors were surveyed by the Association of Program Directors in Internal Medicine (APDIM) in August 2012 on the state of cost-conscious care curricula.

The researchers found that 79.7 percent of the 370 programs responded to the APDIM survey. Only 14.9 percent of respondents reported having a formal cost-conscious care curriculum, while 49.8 percent reported that a curriculum was in progress. The most common teaching methods among programs with a formal curriculum included didactic teaching (97.4 percent) and informal discussion (76.9 percent), and assessments were most frequently by faculty (41.0 percent) or were absent (38.5 percent). Most programs (84.9 percent) agreed that graduate medical education had a responsibility to limit the increasing cost of health care, but only 57.5 percent reported that most of their faculty consistently practiced cost-conscious care, and only 33.2 percent reported that residents had access to information relating to costs of tests and procedures.

"Despite the national consensus among policy makers and educators on medical education's role in cost-conscious care, less than 15 percent of programs had a formal curriculum, while approximately 50 percent of programs were working on one," the authors write.

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