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June 18, 1982

The Examination of 'Routine' Tests

JAMA. 1982;247(23):3183. doi:10.1001/jama.1982.03320480011006

To the Editor.—  Our health care system has spawned a rise in costs that is rightfully alarming the nation. Unquestionably, physicians are responsible. We as physicians allocate the finances that are available for health expenditures; ie, we decide what diagnostic and treatment modalities will be purchased. Unless we stop the rising costs, our professional freedom will be lost in the coming public and private reactions.Furthermore, health expenditure per physician will decline even with no overt wresting of power from physician to legislators and thirdparty creditors. Economic forces that presently exist are enough to ensure it.1Therefore, physicians must reevaluate methods of diagnosis and treatment to provide maximum health care per dollar expended. As an example of a possible solution, we examined the "routine" preoperative upper gastrointestinal series (UGIS) for people with documented gallbladder (GB) disease. This is a procedure universally recommended to rule out a concomitant pathological condition.