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May 19, 1989


JAMA. 1989;261(19):2840-2841. doi:10.1001/jama.1989.03420190116033

During the past year, both the lay and professional press recorded mounting concern about the economic consequences of clinical decision making. Business pages of major newspapers described the new emphasis on introducing cost-saving medical products (New York Times. October 4, 1988:34). The 1988 edition of a prestigious medical textbook1 asserted, "It is the physician's responsibility not only to hold down costs for society overall but also to know what the costs of tests and treatment are for individual patients and how much of the cost the patient will have to bear." The editor of a major journal heralded the advent of a new era in health care, when better information about costs and benefits will mean that "physicians will be in a much stronger position to advise their patients and determine the use of medical resources. "2 This excitement about the value of improved data on the cost-effectiveness of