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Karl A. Poterack, MD
Milwaukee, Wis

JAMA. 1989;261(16):2327.

	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.—

The results of the Resource-Based Relative Value Scale study provide some thought-provoking comparisons.¹ Table 2 in that article reveals that both carpal tunnel surgery (427 resource-based relative values) and a vasectomy (472 resource-based relative values) are considered to be of significantly more value than the resuscitation of the high-risk neonate in the delivery room (276 resource-based relative values). Cervicocerebral angiography (621 resource-based relative values) is more than twice as valuable as neonatal resuscitation.

Without in any way minimizing the skill, time, or risk that my colleagues invest in any of these procedures, I ask: "Valuable to whom?" To the patients who benefit from these services? To the physicians who perform them? Or to the government that pays for them?—a truly frightening, albeit most likely, answer. It would be interesting to see this concept applied to other areas of government expenditure, for instance, welfare and social security . . . [Full Text PDF of this Article]

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