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Robert L. Mullin, MD
Hospital of Saint Raphael New Haven, Conn

JAMA. 1986;255(11):1435.

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In Reply.—

I am sorry that Dr Thompson missed the point of the article. I did not "try to blame DRGs' shortcomings on the ICD-9-CM coding system"; rather, I was trying to point out the ICD-9-CM shortcomings, which affect a great deal more than the DRGs, as explained in the article.

We have, in the New Haven area, used physician profiles, case mix adjusted using DRGs, successfully for about five to six years. Our physicians have accepted these profiles as valid and do not all claim to "treat the sickest ones."

Dr Thompson, by overlooking the problems with the current coding system, only reinforces my position that physicians must take the lead in revising this coding system. . . . [Full Text PDF of this Article]

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