In the Journal of the National Cancer Institute, Nancy Keating wrote an editorial about the role of physicians in explaining area-level variations in health care spending.

Using data from the Surveillance, Epidemiology, and End Results–Medicare program, a recent study assessed whether physicians’ use of magnetic resonance imaging (MRI) and positron emission tomography (PET) for patients with cancer were influenced by their peers’ use of these tests  The study focused on these two tests because they have unproven benefits as they were just being adopted during the study period. They found that physicians whose peers ordered more of these tests in turn prescribed more MRIs and PETs than physicians whose peers ordered fewer.

In the paper, Keating said,

“The application of network methods has great potential to further our understanding of how physicians influence their peers. The findings by Pollack and colleagues support the hypothesis that peer influence is a driver of physicians’ practice styles and raise the possibility that leveraging such influence may provide opportunities to limit the adoption and use of low-value care.”

Physician behavior, Keating notes, is particularly hard to change and a variety of strategies that include engaging physicians and their peers may be useful to supplement approaches such as financial incentives and administrative interventions. 

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