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February 4, 1983

Demand v Need v Physician Prerogatives in the Use of the WBC Differential

Author Affiliations

From the Departments of Pathology (Drs Rock and Grogan) and Public Health and Preventive Medicine (Dr Grogan), Louisiana State University School of Medicine; and the Quality Assurance (Dr Grogan) and Pathology (Dr Rock) Departments, Charity Hospital, New Orleans. Dr Grogan is now with the Office of Medical Affairs, Erlanger Medical Center, Chattanooga, Tenn.

JAMA. 1983;249(5):613-616. doi:10.1001/jama.1983.03330290035025

The clinical use of the WBC differential was investigated before and after it was made available on demand. The results indicate that no consistent policy existed in our hospital for the ordering of a differential. When differentials were made available on demand, the number of differentials did not increase compared with earlier periods. The demand for differentials may have been caused more by the denial of a physician's prerogative to order a differential rather than by its requirement for patient care.

(JAMA 1983;249:613-616)