Cost Containment and the Physician

摘要: The rapid rise in health care costs is receiving a good deal of attention these days. Proposed responses include the deliberate rationing expensive medical technologies, such as organ transplantation, and redirection our efforts toward preventive care. Although may improve health, it cannot be assumed to reduce costs, since later death an earlier one. I suggest that major rapidly growing component stems from widespread application tests procedures when they are no demonstrated benefit even harmful. Identifying curtailing unnecessary care, rather than beneficial should thrust cost-containment efforts. Fee schedules revised so neither encourage nor discourage use procedures; we undertake systematic studies assess technologies practices; make every effort practice defensive medicine. involvement physicians not only premature; also inconsistent with role advocates for patients. ( JAMA 1985;254:1203-1207)