(Arch Intern Med. Published online November 19, 2012. doi:10.1001/2013.jamainternmed.727.)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
Commentary: Failure to Curb Excess Testing
In an accompanying commentary, Jerome P. Kassirer, M.D., of Tufts University School of Medicine, Boston, and Arnold Milstein, M.D., M.P.H., of Stanford University School of Medicine, Palo Alto, Calif., write: "After decades of attention to unsustainable growth in health spending and its degradation of worker wages, employer economic vitality, state educational funding and fiscal integrity, it is discouraging to contemplate the fresh evidence by Welch et al of our failure to curb waste of health care resources."
"To avoid reading an almost identical article about unwarranted geographic variations in these pages 10 years from now, physicians will need to support expansion of peer-designed active electronic clinical guidance systems and faster retirement of fee-for-service incentives," they continue.
"No matter what future payment system is implemented, some intercession in clinical decision making will be required to protect patients from too many tests and from too few tests. We have not come close to getting it right," they conclude. (Arch Intern Med. Published online November 19, 2012. doi:10.1001/.jamainternmed.2013.1780.)
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