In this preliminary study of a two-state region, we found that physicians were taking the initiative to counsel their patients about Medicare Part D, despite the fact that they did not perceive this function to be their responsibility. Their actions, in turn, might have demonstrated a significant aspect of professionalism Q.e., altruism), because physicians were filling a void and were considering their patients’ best interests.

Our study has several implications for patients, physicians, and policymakers. tadalis sx

First, our finding of low perceived responsibility to act as the patient’s Medicare Part D advocate may be explained, in part, by the fact that physicians might not have the information they need to counsel their patients about the Medicare drug benefit. In this study, the majority of physicians indicated that they were aware of the patient’s medication regimen but were unaware of their patients’ annual drug costs, information about the content of the formulary that would best serve the patient, or the least expensive plan for the patient. This finding was significant, because research suggests that patient-physician communication is compromised when physicians do not feel that they have viable solutions to offer their patients.

Second, we found an association between access to information and physicians’ perceived responsibility for advising seniors about Part D enrollment. Access to information could be a precondition to providing advice. Patients’ expectations about obtaining their physicians’ assistance with Part D may go unmet if physicians do not have ready access to the necessary information.

Third, we found an association between using information technology (a PDA or computer order entry or both) when prescribing and having access to information. In addition, as with a previous study in which generalists had been found to be more familiar with patients’ formularies, we found that gener-alists, compared with specialists, were more familiar with the patient’s medication regimen, were more likely to advise their senior patients about enrollment, were more familiar with Medicare Part D, and were more likely to use information technology (e.g., a PDA) when prescribing. These results suggest that efforts to overcome information barriers can enable physicians to access pertinent information rapidly and may lead to a greater ability on the part of physicians to counsel patients about Part D.
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We also found that physicians practicing in complex prescribing environments (prescribing from six or more formularies) had greater access to information and a greater likelihood of advising patients about Part D enrollment. It is logical to assume that physicians who are accustomed to dealing with multiple drug formularies are more adept at explaining the intricacies of Part D benefits to their patients than physicians who practice in less complex environments.

LIMITATIONS OF THE STUDY

Our study has several limitations.

This study reflected the perceptions of physicians who were members of the Minnesota Medical Association and North Dakota Medical Associations at the time, and a response rate of 48% might be considered a possible limitation.

An inherent limitation was our focus on only two states, and it is possible that the findings of this study might differ from those of a national survey. Conversely, we believe that there is no a priori reason to assume that physicians practicing in other parts of the U.S. would differ in their perceptions of Medicare Part D.

Similar to our study, in which most physicians indicated that their familiarity with Medicare Part D was below average, a national survey of physicians regarding Medicare Part D found that most physicians (64%) reported that they understood the benefit “not too well” or “not well at all.”¹ Nonetheless, a future study representing a national sample might be needed with convergent findings before these findings can be generalized nationally.
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As with any survey, our findings might be subject to a non­response bias and a socially desirable response bias. A similar study that used a comparable survey tool, exclusive of Medicare Part D, also showed a 49.6% response rate. In that study, a telephone follow-up of 69 randomly selected non-responders (13%) was conducted, and it was determined that the populations of non-responders and responders were similar.

CONCLUSION

Despite the limitations of our study, our findings might be helpful in developing tools that address physicians’ need to access information so that they can counsel their patients about Part D. Alternatively, it is also possible that other factors besides access to information might mold physicians’ perceptions of the need to assist their patients with Part D. Nevertheless, as more senior citizens join the program, their demand for physician guidance will increase.

In general, even though many physicians perceive that it is not their responsibility to act as their patients’ Part D advocates, many of them do provide such assistance. This may be seen as evidence of their professionalism.

Although we believe that we did not establish a clear link in our study between the variables examined, our findings show that several attributes describe physicians who were more likely to advise patients about Part D. Among these were physicians’ access to information about the patient’s medication regimen, the use of a PDA when prescribing, and the complexity of the prescribing environment in which the physicians practiced. These findings suggest that physicians who have easy access to information and are accustomed to dealing with multiple formularies are more likely than their peers to advise their patients on Part D. Conversely, physicians with poor access to real-time information and minimal acquaintance with formulary prescribing are less likely to feel confident about advising their Part D patients.
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Although very few physicians in this study felt that it was their responsibility to advise patients about enrollment in Part D, those who possessed the requisite information and experience were likely to do so. Providing physicians with access to requisite information may facilitate the process of advising patients, which may be especially important during periods of open enrollment for Part D.