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Alan B. Hollingsworth, MD
Daniel Freeman Marina and Memorial Hospitals Marina del Rey, Calif

JAMA. 1985;254(11):1449.

	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.—

With regard to recent JAMA articles and letters addressing "do not resuscitate" (DNR) orders,^1-3 a new specter appears on the horizon that might compound the complexities of this issue even further. Now that our government has received its MD degree from an unknown diploma factory (rumored to be in the Caribbean) and has entered the practice of "quality care medicine" through peer review organizations (PROs), we have noticed at my hospital's utilization committee meeting that our state's PRO (California Medical Review, Inc) has denied inpatient Medicare payment for all days beyond that moment when the DNR order was placed on the chart. This has occurred for two patients, wherein both instances the PRO made no reference to the DNR order as a deciding factor in denial of payment. Apparently, we are to believe that this is a simple coincidence, although both patients clearly needed further acute . . . [Full Text PDF of this Article]

Footnotes
Edited by Drummond Rennie, MD, Senior Contributing Editor, Sharon Iverson, Assistant Editor.

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