“There is a widespread belief in health care that the deficiency in information and medical knowledge among consumers is the key barrier to achieving high-quality health outcomes and lower costs of care,” the authors write. “An enormous number of health policies follow from this assumption, including efforts to educate patients about health, both at a population level through large-scale public health campaigns (e.g., campaigns to encourage exercise and healthier diets) and at an individual level through provider-led patient education (e.g., education of patients about the inappropriateness of antibiotics for the common cold, the importance of vaccination, etc.).”

Doctor knows best?

The researchers started with the theory that physicians would have much more access to, and familiarity with, high-quality information when it comes to health care. The study aimed to test the upper boundaries of how information plays a role in health care choices, the researchers said, since most members of the general public were not likely to be better informed than physicians.

Using a military database that covers active service members; their families; and retirees; and was able to identify patients who were also physicians, the study looked at ten years of data. The researchers assessed whether patients received “high-value” or “low-value” services.

“An example of low-value care is a chest X-ray before eye surgery, a very low risk procedure for which pre-operative diagnostic testing is not recommended,” the study said. “An example of high-value care would be statin therapy for patients with cardiovascular disease.”

Mixed results

The researchers say that in many cases, physicians did not make significantly different choices than less-educated patients.

“Our results suggest that physicians do only slightly better than non-physicians—but not by much and not always,” the study said. “Across most of our low-value settings, physicians receive less low-value care than do non-physicians, but the differences are modest.”

The study said it's likely that factors other than information may play a large role in health care decision-making. For example, they suggest that high-information physicians make low-value choices in some cases because of time pressures. In addition, the study suggests that physician patients, just like non-physician patients, seem more likely to follow the recommendation of their health care provider, even when that recommendation falls into the low-value category.

The study is a working paper that has not yet been peer-reviewed; and while the authors acknowledge that their findings have some limitations, they say that the report suggests there may be limits on the benefits of patient education.

“Our results consistently suggest that, at most, superior patient knowledge is associated with only modest improvements in the quality of care selected through medical encounters,” the study concludes.

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