February 22, 1971

Screening Tests in Ambulatory Practice

Author Affiliations

San Francisco

JAMA. 1971;215(8):1328. doi:10.1001/jama.1971.03180210072027

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To the Editor.—  The paper by Bates and Mulinare ("Physicians Use and Opinions of Screening Tests in Ambulatory Practice," 214:2173, 1970) deserves to become a classic of interrogative research in which the answers are built into the questions.The authors found that physicians had a significant "unmet need" for additional screening tests, yet "physicians' dependence on clinical indication and fear of losing medical control may reduce utilization" of such tests, even if they could be supplied cheaply and conveniently. The authors arrive at these conclusions by first asking what additional tests may be desirable and then why they are not used. The physician has a choice between "reluctance to use additional tests without clinical indication," "reluctance to use additional tests because of low yield," and "reluctance because of expense." Physicians' answers are predictably "ambivalent": Physicians do not want to miss anything, therefore opt for more tests. At the same