Back in the days of capitation and other innovative physician payment methods, there was prominent managed care backlash stemming from the potential for conflicts of interest that might keep physicians from recommending expensive but necessary care. A recent study, published in Archives of Internal Medicine , reports on efforts to measure the effect of knowledge on patients' understanding of their physicians' financial incentives and on their level of trust in primary care physicians.
Letters that disclosed details of the compensation system for primary care physicians were sent to patients at two large physician groups in Boston and Los Angeles.
The researchers report that patients who received a disclosure felt more competent to judge the effect of their physician's compensation on their health care, and nearly a quarter of patients who remembered receiving a disclosure reported that it had increased their trust in their primary care physician. Neither disclosure letter decreased patients' trust that that primary care physicians would put their interests above concern for costs.
In neither population did disclosure produce statistically significant changes in levels of trust in primary care physicians. In Los Angeles, for example, 74.8 percent of control patients completely or mostly agreed with the statement that they trusted their primary care physician to put their health and well-being above costs; this level of trust was expressed by 78.6 percent of all disclosure patients and by 82.2 percent of patients who remembered receiving the disclosure.
*Data are given as percentage of patients who completely or mostly agree. There were 2,398 control patients, 2,352 patients who were mailed a disclosure, and 1,270 patients who were mailed a disclosure and who remembered receiving the disclosure.
Source: Arch Intern Med. 2006;166:623–628.