The Physician's Role in Cost Containment

To the Editor.—  The article by Stephen J. Dresnick, MD, and colleagues, "The Physician's Role in the Cost-Containment Problem" (241:1606, 1979), is a timely one. There has been an explosion of laboratory tests that have been developed and are requested by physicians. The number of times that a physician will write a request for daily determination of electrolyte values without putting an end point to it is most disturbing. Even "arterial blood gases" are requested on a regular repetitive basis without any thought as to how these values may alter the clinical treatment of the patient. It peeves me to see physicians ordering daily bilirubin studies on a patient with obstructive jaundice when nothing has been done that is likely to change the bilirubin level dramatically. Surely one study a week would be adequate.One method of bringing to the attention of the physician the enormous costs of medical care