This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

Larry A. O'Brien, MD
Children's Medical Center of Dallas

JAMA. 1986;255(10):1287-1288.

	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.—

Dr Angell,¹ in her article, "Cost Containment and the Physician," outlines the growth of unnecessary medical care and the role of physicians in containing medical costs. A factor that is suggested as crucial is a "revision of fee schedules so that they no longer reward the use of tests and procedures." Dr Angell made it clear before this statement that she was not accusing the majority of physicians of performing "unnecessary tests and procedures simply to make money." I believe she is correct that the majority of physicians do not order tests simply to make money, but there are two significant reasons these tests are ordered.

The first reason is society's expectations for these "little-ticket items." Common are lay accounts of initial vague symptoms that are appropriately dismissed as transient phenomena by a physician (eg, headaches). Later that patient sees another physician who, perhaps with relevant . . . [Full Text PDF of this Article]

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?