Clinical Economics

PUBLIC and professional concern about the cost of medical care has evoked a variety of proposed remedies. Professional societies have promulgated guidelines to help physicians provide the most appropriate services.1,2Government has begun to recognize the need for more research into clinical strategies in hopes of exploring the variations in medical practice and reducing federal health care outlays.3Insurance companies and businesses have desperately sought (and bought) consultants who promise to control beneficiaries' and employees' utilization of medical services. Underlying these cost-cutting solutions is a faith that medical care can be made cost-effective, that more value can be obtained for the money spent. The application of economics to medical practice does not necessarily mean that less should or can be spent, but rather that the use of resources might be more efficient.4-21To achieve more cost-effective medical practice, the attention of experts in health policy ultimately must