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April 5, 1985

Physician Education and Cost Containment

Author Affiliations

Harvard Medical School Boston

JAMA. 1985;253(13):1876. doi:10.1001/jama.1985.03350370056011

To the Editor.—  The conclusion by Schroeder et al1 in their recent article that "in the absence of other cost containing incentives, physician education alone is not an effective hospital cost containment strategy" seems overstated on the basis of their negative findings from a single nonrandomized study. In the prescribing area, for example, our recent randomized controlled trial (n=435 physicians) of targeted, one-on-one educational "detailing" resulted in substantial savings and reductions in unnecessary drug use in the Medicaid sector alone.2 These effects occurred in the absence of either financial incentives or data feedback. We are now completing a formal benefit-cost analysis of these findings, which indicates that with suitable targeting of high-cost physicians, program savings far exceed program costs. Schaffner et al3 have similarly shown success in improving the precision and cost-effectiveness of physicians' clinical decision making.In a broader context, the review of 247 continuing medical