To the Editor.—
It is generally agreed that physicians are largely responsible for determining the type and quality of medical care that their patients receive and the mechanisms through which that care is provided. According to a recent report to the secretary of Health and Human Services by the General Accounting Office (GAO), "Health expenditures increased from $42.0 billion in 1965 (6.1 percent of the gross national product) to an estimated $278.5 billion in 1981,"1 and "it has been estimated that 70 percent of all expenditures for health care are directly influenced, if not controlled, by the decisions of physicians."2The GAO report cites studies showing that increased emphasis on training physicians in cost-containment techniques is likely to produce lower medical costs. Although physicians should avoid being seduced into supporting cost-containment programs for their cost savings alone unless they are consistent with their fundamental ethical concerns and responsibility
Schuman BJ. Continuing Medical Education Training in Medical Cost Management. JAMA. 1984;251(2):217. doi:10.1001/jama.1984.03340260025016
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