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To the Editor.—
The Journal has welcomed the new year with a reminder that, in addition to death, taxes, and the speed of light, there is one other dependable constant: the bureaucratic approach to medical care. Towery and Perry (1981;245:59), examining the question of which tests and procedures should be deemed compensable, reach the now familiar conclusion that medicine is too important to be left to the physicians. Towery and Perry accomplish this in a two-step sequence. In the first step we are told that only "the opinion of experts in a particular area" is acceptable, thus eliminating most of us. But then, in the second step, we learn that even the experts are suspect ("The panel should have a minimum of representation from particular subspecialties that use the technology").That these two lines of reasoning contradict each other is apparently lost on the bureaucratic mentality. Some things never change.
Oxley DK. Evaluating Technologies. JAMA. 1981;245(16):1632. doi:10.1001/jama.1981.03310410012013
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