"The results raise the possibility that (the) more costly practice style of newly trained physicians may be a driver of rising healthcare costs overall," says Mehrotra in the report. "We found a large association between physician experience and lower cost profiles," he adds.
So what about that "costly practice style" of newly trained physicians? For one thing, physicians with less experience may spend more on patients who may need more costly care to begin with, and add to it.
"The higher mean patient costs observed among physicians with less experience appears to be driven by high-cost outlier patients," Mehrotra's report states.
When I interviewed him, Mehrotra theorized several possibilities of why younger physicians spent more than older doctors. "There may have been a situation that reflects clinical uncertainty (among the younger physicians), with them saying, ‘Let's get this test just in case," he says. "A physician who has experience and faced similar clinical situations previously may feel more comfortable just being conservative and watching things through."
Less experienced physicians may follow "costlier practice patterns" than more experienced physicians because recently trained physicians may be "more familiar with and therefore more likely to use newer and more expensive treatment modalities," Mehrotra says in the report. "It is also possible that lack of experience and uncertainty translates into more aggressive care.
As the government moves toward value-based care, physicians with higher costs may sustain reduced reimbursement. In addition, "less experienced physicians will, on average, be negatively affected by policies that use physician cost profiles unless they modify their practice patterns," he adds.