Margaret A.WinkerMD, Deputy EditorIndividualAuthorPhil B.FontanarosaMD, Interim CoeditorIndividualAuthor
To the Editor: The article by Dr Roberts and
colleagues1 on recognizing the importance
of dividing total costs into fixed and variable components deals with an overlooked
nuance for physicians who need to be able to converse with and understand
how their nonphysician colleagues involved in administrative and fiscal activities
think and behave. The article impressively analyzed the split between variable
and fixed costs at an inner-city public hospital. The authors' point regarding
the difference between short-term and long-term perspectives needs to be reinforced.
As reimbursement for health care continues to decrease, there will be a greater
need to shed fixed costs within a shorter time frame and not assume that this
can only be accomplished over a more protracted course.
Propp DA. Fixed vs Variable Costs of Hospital Care. JAMA. 1999;282(7):630. doi:10-1001/pubs.JAMA-ISSN-0098-7484-282-7-jbk0818