Training Linked to Costly Brand Name Prescribing

There is a link between low-value prescribing and graduate medical training, according to a study led by researchers at the Perelman School of Medicine at the University of Pennsylvania and published in the Journal of General Internal Medicine.

A study of 10,151 statin prescriptions across 4 sites found that physicians in training are twice as likely to order a costly brand-name statin when supervised by senior physicians who prefer those medications in their own practice.

"These findings provide early empirical evidence that low-value practices among physicians are transferred from teachers to trainees, highlighting the importance of re-design of graduate medical education," Kira Ryskina, MD, a general internal medicine fellow at Penn, said in a statement. "We observed considerable variation in the prescribing practices of both attending physicians and residents, suggesting room to improve cost-effectiveness."

The probability of a resident prescribing a costly brand-name statin increased from 22.6% for those supervised by physicians who mostly prescribed cheaper generics to 41.6% when they were supervised by an attending who mostly prescribed expensive brand name statins. A higher postgraduate year level was associated with brand-name prescribing.