We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
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 ......

Toward Fewer Procedures and Better Outcomes

Stephen C. Schoenbaum, MD, MPH
JAMA. 1993;269(6):794-796. doi:10.1001/jama.1993.03500060094039.
Text Size: A A A
Published online


In 1987 and 1988 the Health Program at RAND, Santa Monica, Calif, published a series of articles on the appropriateness of various medical procedures that had been performed between 1979 and 1982.1-3 The RAND investigators had developed appropriateness criteria by a specific method in which panels of nine experts reviewed relevant medical literature and then rated a series of clinical scenarios (indications). When the criteria sets were applied to actual patient records, it appeared that a significant percentage of the procedures were unnecessary. The medical and general public pounced on these reports. At last there was evidence that substantial savings might be achieved in health care; and since the savings would derive from the elimination of unnecessary care, there should actually be a concomitant increase in the quality of care.

See also pp 753, 761, and 766.

In this issue of The Journal there are three more articles4-6


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?




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.


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

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

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