Like many of us this time of year, the American College of Physicians has resolved to undertake a bit of belt tightening. Its updated ethics manual, released January 3, advocates that its members (some 132,000 physicians) practice “parsimonious care.” As the manual now states, using “efficient means to effectively diagnose a condition and treat a patient respects the need to use resources wisely and to help ensure that resources are equitably available.” In other words, cost is a factor that physicians should consider.
In this country we have a powerful tradition against taking cost into account when we make medical decisions. The only people who worry about money are the ones who have to write the checks—generally employers and governments.
But now the ACP has put it in writing: Doctors should think about cost. Indeed, it is their ethical responsibility to use resources carefully.
Of course, as with all resolutions, this one is easier to make than it is to keep. Will being “parsimonious” with care mean that doctors will start to think twice about prescribing treatments they think might not be necessary? According to a Kaiser Family Foundation report, as much as 30 percent of all treatment is unnecessary.
These are not easy questions, and the ACP’s manual doesn’t try to answer them. But the statement on “parsimonious care” is an acknowledgment by the medical community that physicians play a part in health care costs.
Writing down a resolution doesn’t make it happen, as we all know, but judging from that statistic about unnecessary care, I hope it does.