Factors Associated with Medical Students’ Attitudes About Cost-Conscious Care: A Mixed-Methods Multi-school Study
- 06-05-2024
- Original Research: Qualitative Research
Published in:
- Authors
- Hunter Niehus, MD
- Ali Noel Gunesch, BS
- Nina Rodriguez, BA
- Julianna Khoury, MD, MBA
- Annie Ma, BS
- Nina Gu, BS
- Thy Cao, DO
- Megan Muller, BA
- Christopher Moriates, MD
- Anne S Linker, MD
- Micah Prochaska, MD, MSc
- David Fish, MD
- Glenn Moulder, MD
- Melissa Stephens, MD
- Patricia A. Carney, MS, PhD
- Andrea Smeraglio, MD
- Published in
- Journal of General Internal Medicine | Issue 1/2025
Abstract
Background
Because physician practices contribute to national healthcare expenditures, initiatives aimed at educating physicians about high-value cost-conscious care (HVCCC) are important. Prior studies suggest that the training environment influences physician attitudes and behaviors towards HVCCC.
Objective
To explore the relationship between medical student experiences and HVCCC attitudes.
Design
Quantitative and qualitative analysis of a multi-institutional survey.
Participants
Medical students from nine US medical schools.
Approach
A 44-item survey that included the Maastricht HVCCC Attitudes Questionnaire, a validated tool for assessing HVCCC attitudes, was administered electronically. Attitudinal domains of high-value care (HVC), cost incorporation (CI), and perceived drawbacks (PD) were compared using one-way ANOVA among students with a range of exposures. Open text responses inviting participants to reflect on their attitudes were analyzed using classical content analysis.
Key Results
A total of 740 students completed the survey (response rate 15%). Students pursuing a “continuity-oriented” specialty held more favorable attitudes towards HVCCC than those pursuing “technique-oriented” specialties (HVC sub-score = 3.20 vs. 3.06; p = 0.005, CI sub-score = 2.83 vs. 2.74; p < 0.001). Qualitative analyses revealed personal, educational, and professional experiences shape students’ HVCCC attitudes, with similar experiences interpreted differently leading to both more and less favorable attitudes.
Conclusion
Students pursuing specialties with longitudinal patient contact may be more enthusiastic about practicing high-value care. Life experiences before and during medical school shape these attitudes, and complex interactions between these forces drive student perceptions of HVCCC.
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- Title
- Factors Associated with Medical Students’ Attitudes About Cost-Conscious Care: A Mixed-Methods Multi-school Study
- Authors
-
Hunter Niehus, MD
Ali Noel Gunesch, BS
Nina Rodriguez, BA
Julianna Khoury, MD, MBA
Annie Ma, BS
Nina Gu, BS
Thy Cao, DO
Megan Muller, BA
Christopher Moriates, MD
Anne S Linker, MD
Micah Prochaska, MD, MSc
David Fish, MD
Glenn Moulder, MD
Melissa Stephens, MD
Patricia A. Carney, MS, PhD
Andrea Smeraglio, MD
- Publication date
- 06-05-2024
- Publisher
- Springer International Publishing
- Published in
-
Journal of General Internal Medicine / Issue 1/2025
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497 - DOI
- https://doi.org/10.1007/s11606-024-08783-x
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