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July 25, 1986

Two Consultations: Cognitive Services vs Procedures

Author Affiliations

New Orleans

JAMA. 1986;256(4):472. doi:10.1001/jama.1986.03380040046021

To the Editor.—  Regarding "Two Consultations," Dr Cowan's1 point regarding relative charges for "cognitive" vs procedural charges is well taken. However, he misses the even more pertinent point that an elderly man with gastrointestinal tract bleeding was hospitalized for five weeks, received multiple transfusions, and supposedly was examined twice—by the admitting physician and a gastroenterologist—without a rectal examination. How does five weeks of hospitalization compare in price with the cost of a rectal examination?