Medicine and Money

Health-care costs studied at medical center
August 1, 2010

Recent Duke studies have analyzed two factors behind rising health-care costs in the U.S.: medical imaging and physician pay.

The first study, conducted by the Duke Clinical Research Institute, found that the number of PET (positron emission tomography) scans performed on cancer patients is growing rapidly, leading to a doubling of the amount spent by Medicare on medical imaging, compared with the overall costs of cancer care. PET scans reveal important information about the anatomy and other aspects of a tumor and are a relatively recent innovation. They can be six times as expensive as CT (computed tomography) scans.

Still, imaging costs account for only 6 percent of the total Medicare budget for treatment of cancer patients, researchers say. They are uncertain why imaging costs are growing so quickly or whether more PET scans necessarily lead to greater success in treating cancer.

The second study, which began as part of a class project in the health-sector-management program at the Fuqua School of Business, compared the earnings of primary-care physicians and specialists. The researchers found that specialists earned $2.7 million more than primary-care physicians over the course of a career, which has contributed to fewer medical students choosing to enter family or internal medicine.

Researchers say that a shortage of primary-care physicians will become increasingly problematic in the wake of health-care reform, which is projected to give greater access to medical care to 32 million previously uninsured people.