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December 19, 1977

Problem-Oriented Approach to Practice

Author Affiliations

Hunterdon Medical Center Flemington, NJ

JAMA. 1977;238(25):2697. doi:10.1001/jama.1977.03280260027008

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To the Editor. —  The article by Tufo and associates on the problem-oriented approach to practice may or may not substantiate economical use of services by the population that his group served. They state that 50% of all professional services were incurred outside of their plan and that the bed days in 1976 per thousand patients approximated just under 1,000.I would conclude that the total bed days for their patients approximated just under 2,000, which is almost double the average for the state of New Jersey for Blue Cross patients served by all physicians regardless of how they practice.The authors do not make mention of the social level of their population other than to say it has not changed. Social class levels as well as age are among important determiners of health care use. They will have to demonstrate experience of their population versus some other population before we