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Nobody's Fault: Physicians Must Fight for Care That Is Necessary

Bruce L. Wilder, MD
JAMA. 1987;258(5):611. doi:10.1001/jama.1987.03400050053018.
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To the Editor.—  I was greatly disturbed after reading the well-written account of a serious complication following cataract surgery, entitled "Nobody's Fault."1I could not better express what must have been the feelings of all those involved better than Dr Strahlman did. What was most disturbing, however, was that an apparently competent, sensitive, and caring physician seemed so resigned to the idea that "the decision to admit patients to the hospital before surgery is no longer in the hands of physicians."If ever there were a self-fulfilling prophecy, Dr Strahlman's final paragraph has illustrated it all too well.When we as physicians believe that certain care is necessary, we should not permit insurers to deny payment because the services are considered unnecessary without clearly expressing our opinions that the services are necessary and that they should be covered. True, payment may be denied anyway, and the patient may be

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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.
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