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We have the impression that Dr Finley has placed the cart before the horse. He points out that the inherent costs of running a hospital are great and that hospitals are having financial difficulties. He suggests that physicians should maximize efficiency by altering their ordering habits so as to meet "thresholds."The fact remains that the practice of medicine is the total knowledge that the physician has acquired through schooling and experience, together with the judicious choice of diagnostic procedures and therapeutics. It is the obligation of every physician to order only what is necessary. Increased awareness of the cost of medical care may provide an added stimulus for physicians to review more critically their reasons for ordering supplies, laboratory tests, and services for their patients.If, as a result of the prudent practice of medicine by physicians, there are losses of income in selective departments in a
Roth WI, Dresnick SJ. Medical Costs-Reply. JAMA. 1980;243(2):118-119. doi:10.1001/jama.1980.03300280016009