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Comment & Response
May 2019

Teaching High-Value Care Through Conscious Ordering of Diagnostic Tests

Author Affiliations
  • 1Department of Internal Medicine, Morehouse School of Medicine, Atlanta, Georgia
JAMA Intern Med. 2019;179(5):732. doi:10.1001/jamainternmed.2019.0017

To the Editor We read with great interest a recent Research Letter by Geleris and colleagues1 regarding the diagnostic test ordering habits among internal medicine residents. The fact that some residents ordered 7 to 8 times more tests than their peers, with an increased incidence in the postgraduate first year, may indicate a cultural norm in medicine that contrasts with the teaching of high-value care. However, the total number of tests is hard to comprehend without knowing the relation to acuity of care. One might imagine that patients in intensive care units, for example, may be subject to more testing.

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