To the Editor.
—The rise in medical costs and the need for cost containment are realities. My concern is that those of us who are "proceduralists"—we who look at what we are doing— must try to devise methods that are more efficient and more economical without jeopardizing the patient's safety and without attaining less desirable results just to reduce costs.When I began promoting the idea of 1-day anterior cruciate ligament (ACL) reconstruction surgery for our patients in an outpatient clinic and patient-controlled analgesia (PCA), I confronted all sorts of objections from my colleagues, nursing staff, and patients. After approximately 160 consecutive cases under the outpatient ACL-PCA protocol at our clinic, I can document and demonstrate excellent results with a net savings of approximately $5000 per patient or $800 000 to whomever pays the bill. The net savings takes into account the cost of PCA and home health care. These
Highgenboten CL. Outpatient Anterior Cruciate Ligament Reconstruction and Patient-Controlled Analgesia. JAMA. 1992;268(24):3432. doi:10.1001/jama.1992.03490240040023