Trainees struggle with estimating costs of imaging exams

Most radiology trainees don’t know the cost of common imaging examinations, according to a recent study published by the American Journal of Roentgenology.

Arvind Vijayasarathi, MD, PhD, of Emory University School of Medicine's department of radiology and imaging services, and colleagues surveyed more than 5,300 U.S. residents and fellows who were also members of the American College of Radiology, asking them to estimate Medicare-allowable fees for five different exams.

The exams asked about were: two-view chest radiography, contrast-enhanced CT of the abdomen and pelvis, unenhanced MRI of the lumbar spine, complete abdominal ultrasound, and unenhanced CT of the brain.

Overall, a total of 1,066 individuals completed and returned the survey, and just more than 17 percent of all responses were accurate. Meanwhile, more than 65 percent of the responses were too high, and more than 17 percent were too low.

In addition, more than 45.1 percent of respondents incorrectly estimated the cost of all five examinations.

Vijayasarathi et al. added that, contrary to what one might assume, individuals with formal education in areas such as health care economics did not necessarily submit more accurate estimates

“Very few trainees received more than an hour of education in formal health policy or economics per month; however, these individuals performed no better than those who received no education at all,” the authors wrote. “Similarly, trainees with an advanced education in economics, health policy, or both performed no better than trainees without an advanced education. Therefore, although our study indicates that radiology trainees have a poor grasp of the costs of the services that they commonly perform, it also highlights that current curricula are inadequately filling this gap in the knowledge of the trainees.”

The authors did point out that, in the past, research on other specialties has produced similar results.

“With regard to their poor knowledge of service costs, radiologists are not unique,” the authors wrote. “Previous studies have shown that physicians across a number of specialties inaccurately estimate health care costs.”

The two examples they specifically mentioned focused on pediatricians and orthopedic surgeons.

The authors also noted that, in a way, it’s not fair to expect radiologists to instantly know the cost of each exam they may encounter, and that’s where tools such as clinical decision support come into play.

“Including cost information in such platforms would be a relatively easy programming task and thus could prove to be an easily implementable and very effective manner of making cost information available to both referring physicians and radiologists in real-time during patient care,” the authors wrote.