Are physicians responsible for reducing costs?

According to a recent paper in JAMA [JAMA. 2013;310(4):380-388. doi:10.1001/jama.2013.8278], the answer seems to be no. The authors surveyed (randomly) physicians from the AMA masterfile. They had a decent response rate (56%) and sample size (n = 2556). Only 36% reported that practicing physicians have a responsibility to reduce costs. The authors argue that the picture is complex and that this raw statistic hides the devil in detail. For example, 78% reported that (78%) and that “doctors need to take a more prominent role in limiting use of unnecessary tests”. Looking at the data from an organizational perspective, I wonder whether the data reveal something important about the way that doctors feel that they do not belong to their organisations. Thus, the data might be a symptom of a more serious malady. The feeling that one does not fully belong to an organisation is unlikely to be fixed by changing payment plans.