"On one hand, the majority of physicians were very willing to say, 'I need to go to go to bat for my patients even when it's expensive.' But at the same time, a majority also endorsed the idea—they were perfectly comfortable with—having limits on insurance coverage for marginally beneficial therapies."
But on reflection, Tilburt says, "we don't think that's contradictory to doing the best for our patients. Doing the best for patients often means starting with good, sound, tried-and-true old therapies and moving to more fancy bells and whistles down the road."
The survey revealed some other significant findings about physician attitudes as well.
Eighty-five percent of responders said they "should sometimes deny beneficial but costly services to certain patients because resources should go to other patients that need them more."
Nearly half (42%) strongly agreed with the statement "Doctors need to take a more prominent role in limiting use of unnecessary tests," and 47% moderately agreed with that statement.
Asked their views on the statement, "It is unfair to ask physicians to be cost-conscious and still keep the welfare of their patients foremost in their minds," 14% strongly agreed and 28% moderately agreed, while 58% moderately or strongly disagreed.
In an accompanying editorial, Ezekiel Emanuel, MD, and Andrew Steinmetz, BA, of the Department of Medical Ethics and Health Policy of the Wharton School at the University of Pennsylvania, wrote that the Tilburt survey results "are somewhat discouraging" because "they suggest that physicians do not yet have that 'all-hands-on-deck' mentality this historical moment demands."