Physician trainees' decision making and information processing: choice size and Medicare Part D.

Many patients expect their doctor to help them choose a Medicare prescription drug plan. Whether the size of the choice set affects clinicians' decision processes and strategy selection, and the quality of their choice, as it does their older patients, is an important question with serious fina...

Full description

Bibliographic Details
Main Authors: Andrew J Barnes, Yaniv Hanoch, Melissa Martynenko, Stacey Wood, Thomas Rice, Alex D Federman
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2013-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC3792159?pdf=render
_version_ 1818997777455120384
author Andrew J Barnes
Yaniv Hanoch
Melissa Martynenko
Stacey Wood
Thomas Rice
Alex D Federman
author_facet Andrew J Barnes
Yaniv Hanoch
Melissa Martynenko
Stacey Wood
Thomas Rice
Alex D Federman
author_sort Andrew J Barnes
collection DOAJ
description Many patients expect their doctor to help them choose a Medicare prescription drug plan. Whether the size of the choice set affects clinicians' decision processes and strategy selection, and the quality of their choice, as it does their older patients, is an important question with serious financial consequences. Seventy medical students and internal medicine residents completed a within-subject design using Mouselab, a computer program that allows the information-acquisition process to be examined. We examined highly numerate physician trainees' decision processes, strategy, and their ability to pick the cheapest drug plan-as price was deemed the most important factor in Medicare beneficiaries' plan choice-from either 3 or 9 drug plans. Before adjustment, participants were significantly more likely to identify the lowest cost plan when facing three versus nine choices (67.3% vs. 32.8%, p<0.01) and paid significantly less in excess premiums ($60.00 vs. $128.51, p<0.01). Compared to the three-plan condition, in the nine-plan condition participants spent significantly less time acquiring information on each attribute (p<0.05) and were more likely to employ decision strategies focusing on comparing alternate plans across a single attribute (search pattern, p<0.05). After adjusting for decision process and strategy, numeracy, and amount of medical training, the odds were 10.75 times higher that trainees would choose the lowest cost Medicare Part D drug plan when facing 3 versus 9 drug plans (p<0.05). Although employing more efficient search strategies in the complex choice environment, physician trainees experienced similar difficulty in choosing the lowest cost prescription drug plans as older patients do. Our results add further evidence that simplifications to the Medicare Part D decision environment are needed and suggest physicians' role in their patients' Part D choices may be most productive when assisting seniors with forecasting their expected medication needs and then referring them to the Medicare website or helpline.
first_indexed 2024-12-20T21:51:01Z
format Article
id doaj.art-53de88661f7d4a2e8bd0cfe485fee2b8
institution Directory Open Access Journal
issn 1932-6203
language English
last_indexed 2024-12-20T21:51:01Z
publishDate 2013-01-01
publisher Public Library of Science (PLoS)
record_format Article
series PLoS ONE
spelling doaj.art-53de88661f7d4a2e8bd0cfe485fee2b82022-12-21T19:25:33ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-01810e7709610.1371/journal.pone.0077096Physician trainees' decision making and information processing: choice size and Medicare Part D.Andrew J BarnesYaniv HanochMelissa MartynenkoStacey WoodThomas RiceAlex D FedermanMany patients expect their doctor to help them choose a Medicare prescription drug plan. Whether the size of the choice set affects clinicians' decision processes and strategy selection, and the quality of their choice, as it does their older patients, is an important question with serious financial consequences. Seventy medical students and internal medicine residents completed a within-subject design using Mouselab, a computer program that allows the information-acquisition process to be examined. We examined highly numerate physician trainees' decision processes, strategy, and their ability to pick the cheapest drug plan-as price was deemed the most important factor in Medicare beneficiaries' plan choice-from either 3 or 9 drug plans. Before adjustment, participants were significantly more likely to identify the lowest cost plan when facing three versus nine choices (67.3% vs. 32.8%, p<0.01) and paid significantly less in excess premiums ($60.00 vs. $128.51, p<0.01). Compared to the three-plan condition, in the nine-plan condition participants spent significantly less time acquiring information on each attribute (p<0.05) and were more likely to employ decision strategies focusing on comparing alternate plans across a single attribute (search pattern, p<0.05). After adjusting for decision process and strategy, numeracy, and amount of medical training, the odds were 10.75 times higher that trainees would choose the lowest cost Medicare Part D drug plan when facing 3 versus 9 drug plans (p<0.05). Although employing more efficient search strategies in the complex choice environment, physician trainees experienced similar difficulty in choosing the lowest cost prescription drug plans as older patients do. Our results add further evidence that simplifications to the Medicare Part D decision environment are needed and suggest physicians' role in their patients' Part D choices may be most productive when assisting seniors with forecasting their expected medication needs and then referring them to the Medicare website or helpline.http://europepmc.org/articles/PMC3792159?pdf=render
spellingShingle Andrew J Barnes
Yaniv Hanoch
Melissa Martynenko
Stacey Wood
Thomas Rice
Alex D Federman
Physician trainees' decision making and information processing: choice size and Medicare Part D.
PLoS ONE
title Physician trainees' decision making and information processing: choice size and Medicare Part D.
title_full Physician trainees' decision making and information processing: choice size and Medicare Part D.
title_fullStr Physician trainees' decision making and information processing: choice size and Medicare Part D.
title_full_unstemmed Physician trainees' decision making and information processing: choice size and Medicare Part D.
title_short Physician trainees' decision making and information processing: choice size and Medicare Part D.
title_sort physician trainees decision making and information processing choice size and medicare part d
url http://europepmc.org/articles/PMC3792159?pdf=render
work_keys_str_mv AT andrewjbarnes physiciantraineesdecisionmakingandinformationprocessingchoicesizeandmedicarepartd
AT yanivhanoch physiciantraineesdecisionmakingandinformationprocessingchoicesizeandmedicarepartd
AT melissamartynenko physiciantraineesdecisionmakingandinformationprocessingchoicesizeandmedicarepartd
AT staceywood physiciantraineesdecisionmakingandinformationprocessingchoicesizeandmedicarepartd
AT thomasrice physiciantraineesdecisionmakingandinformationprocessingchoicesizeandmedicarepartd
AT alexdfederman physiciantraineesdecisionmakingandinformationprocessingchoicesizeandmedicarepartd