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Richard D. Sautter, MD
Marshfield Medical Foundation Marshfield, Wis

JAMA. 1984;251(8):1027-1028.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

I refer to the article entitled "A Strategy for Cost Containment in Coronary Surgery" by Loop et al.¹ I think it is a notable article reflecting a noble cause with a salutary effect on cost containment.

The editorial by Dr Egdahl also raised important issues regarding surgical fees, especially in cardiac surgery. The fact that the government's plan to reduce the cost of medical care includes plans to decrease physician revenue is overlooked.

I believe that Dr Egdahl's suggestion that open discussion, without the threat of antitrust action, might result in some downward revision of surgical fees is naive. In 22 years I have yet to see substantial reduction in any surgical fee, most especially cardiac surgery. The entire process of establishing surgical fees is wondrous and mysterious. It really resolves down to more or less picking a number. For instance, one coronary vein graft is . . . [Full Text PDF of this Article]

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