Do family physicians know the costs of medical care? Survey in British Columbia

OBJECTIVE To determine the cost of 46 commonly used investigations and therapies and to assess British Columbia family doctors' awareness of these costs. DESIGN Mailed survey asking about costs of 23 investigations and 23 therapies relevant to family practice. A random sample of 600 doctors was asked to report their awareness of costs and to estimate costs of the 46 items. SETTING British Columbia. PARTICIPANTS Six hundred family physicians. MAIN OUTCOME MEASURES Estimates within 25% of actual cost were considered correct. Associations between cost awareness and respondents' characteristics (eg, sex, practice location) were sought. Degree of error in estimates was also assessed. RESULTS Overall, 283 (47.2%) surveys were returned and 259 analyzed. Few respondents estimated costs within 25% of true cost, and estimates were highly variable. Physicians underestimated costs of expensive drugs and laboratory investigations and overestimated costs of inexpensive drugs. Cost awareness did not correlate with sex, practice location, College certification, faculty appointment, or years in practice. CONCLUSION Family doctors in British Columbia have little awareness of the costs of medical care.