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May 2, 2012

Patient Requests for Nonbeneficial Care

Author Affiliations

Letters Section Editor: Jody W. Zylke, MD, Senior Editor.

Author Affiliations: ABIM Foundation, Philadelphia, Pennsylvania (

JAMA. 2012;307(17):1797-1798. doi:10.1001/jama.2012.3572

To the Editor: Drs Brett and McCullough articulated the need for physicians to take responsibility for steering patients away from unnecessary or harmful tests and procedures by “making reasoned judgments about what is beneficial and appropriate and then practicing accordingly.”1 Patient requests for tests that may not be necessary, and the acquiescence by physicians to these requests,2 have helped lead to an inefficient health care system in which resources are often overused—some say as much as 30% of Medicare spending is wasted—at a substantial cost and with little benefit.3

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