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Sarko M. Tilkian, MD
Northridge, Calif

JAMA. 1989;262(11):1468-1469.

	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 started reading the article by Drs Lawhorne and Ringdahl¹ with interest. By the time I finished, I was angry and depressed enough to write this letter. Throughout the article, there was no mention of how vitamin B₁₂ deficiency can be scientifically assessed for clinical purposes.

Current practice seems to emphasize the art of medicine, and also the economics of medicine under the guise of cost containment, at the expense of science. The workup of a patient with vitamin B₁₂ problems can be expensive and inconclusive, but it can also be objective and scientific with minimum cost.² One does not have to do Schilling or deoxyuridine suppression tests, measure vitamin B₁₂ levels, perform gastrointestinal series, etc, which are expensive and sometimes uninformative. There are simple tests that every physician orders routinely but perhaps does not look at critically.

For example, the . . . [Full Text PDF of this Article]

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