0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Letters |

Patient Requests for Nonbeneficial Care

Ami Laws, MD
JAMA. 2012;307(17):1797-1798. doi:10.1001/jama.307.17.1797-b.
Text Size: A A A
Published online

Extract

To the Editor: The article on the obligation of physicians to provide high-quality, cost-effective medicine even in the setting of patient requests for nonbeneficial interventions1 was thoughtful, but a number of points warrant more discussion. First, how does the fact that patients do not pay for interventions at the point of service figure into their requests? In the example of the patient who wanted a magnetic resonance imaging (MRI) scan, Drs Brett and McCullough asserted that the physician should not order the scan even if the patient offered to pay out of pocket. However, it seems unlikely the patient would have been as curious if he had had to write a check for several thousand dollars at the time of the scan. But because he has already paid thousands of dollars for health insurance, why not allocate a few thousand of those “to see what's going on”? This is one example of how the very structure of the current health care insurance and reimbursement system drives costs upward. The system—and the article—put the onus of holding the line on unnecessary spending solely on the physician.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

May 2, 2012
Christine K. Cassel, MD
JAMA. 2012;307(17):1797-1798. doi:10.1001/jama.2012.3572.
May 2, 2012
Allan S. Brett, MD; Laurence B. McCullough, PhD
JAMA. 2012;307(17):1797-1798. doi:10.1001/jama.2012.3611.
CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Collections
PubMed Articles
Jobs
JAMAevidence.com
brightcove.createExperiences();