The need for physician education in health care costs to enhance efficiencies in care delivery.

The article by Rock et al in this issue of Pediatrics highlights an important issue surrounding the challenge of high health care costs in the United States: the lack of knowledge by physicians of cost of care. Their research provides 3 key messages that can inform future health care policies. First, physicians generally have limited knowledge regarding health care finances. As noted by Rock et al in their research, this “knowledge does not improve with experience: attendings’ estimates were, on average, accurate only 4% more frequently than those of residents.” Second, there is very limited transparency in costs of health care. Even when charge information is available, this information may not easily be converted into costs because the charge-to-cost ratios are generally viewed as proprietary by health care organizations. Third, there is a growing recognition that physicians need to have competency of managing health care costs, and groups such as the Accreditation Council for Graduate Medical Education are now expecting this competency for physician education.