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April 5, 1985

Physician Education and Cost Containment-Reply

Author Affiliations

University of California San Francisco

JAMA. 1985;253(13):1876-1877. doi:10.1001/jama.1985.03350370056012

In Reply.—  Soumerai and Avorn take issue with the conclusions that we drew from a recent prospective cost containment experiment at the University of California, San Francisco. Based on our study and other published (and unpublished) work, we concluded that "in the absence of other cost containing incentives, physician education alone is not an effective hospital cost containment strategy."Frankly, we are puzzled by their objections. Our study was prospective and randomized, with concurrent control groups. Contrary to what Soumerai and Avorn suggest, as described in our article, we had sufficient statistical power to detect an economically significant difference between the intervention and control groups had it occurred.They cite in refutation two studies that show changes in prescribing patterns by community-based physicians for Medicaid patients after educational interventions. One of these studies dealt only with prescribing in office practices1; the other appears to be limited to office prescriptions,