As a consultant, I am occasionally asked if I can assist with reducing test utilization. I recently read a Wall Street Journal article (among others) entitled “Reducing Unnecessary Blood Tests By Telling Doctors the Cost” that refers to an article published in Archives of Surgery, “Surgical Vampires and Rising Health Care Expenditure.” In short, the article refers to a fairly short 11 week study that was done to make residents at a tertiary care hospital aware of the daily charges for phlebotomy, and at least during the duration of the study they saw a significant reduction in orders, which translated into a $$ savings.
A quick Google search shows that many news outlets picked up this story, as they should, but I have some concerns.
My main concern about the study (other than the use of Vampire in the title) is that it was only for an 11 week period, and the authors of the study admit “The study didn’t continue past 11 weeks, so it’s not possible to know whether the behavior changes would continue.” My understanding is that similar studies have been conducted in the past, and that each one showed that for short periods ordering patterns can be changed, but that there may be no studies that actually monitored ordering patterns over the long term to see if the change in ordering patterns was maintained. In addition, if they hear a message over and over again, do physicians eventually tune out?
If you have performed a study at your facility and are continuing to monitor, please send me an email.