Jeremy D. Graham, MA, DO; Darryl K. Potyk, MD; Elise D. Raimi, MSPH
Potential Conflicts of Interest: None disclosed.
Graham J., Potyk D., Raimi E.; Providing High-Value, Cost-Conscious Care. Ann Intern Med. 2011;155:857. doi: 10.7326/0003-4819-155-12-201112200-00013
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Published: Ann Intern Med. 2011;155(12):857.
TO THE EDITOR:
We read with interest Weinberger's recommendation (1) that cost-consciousness become a seventh core competency in graduate medical education. The existing competency of systems-based practice is “manifested by actions that demonstrate an awareness of and responsiveness to the larger context and system of health care ... ” (2). This arguably already includes cost-consciousness but is in such general language that high costs are largely unaddressed in training and practice. We concur with Weinberger that cost-awareness should be an explicit competency. In addition, we emphasize that meaningful cost-conscious behavior by a physician is currently constrained by unaddressed structural factors.
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