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Which Shall It Be?

Alfred Soffer, MD

Arch Intern Med. 1985;145(11):1963-1964.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

The title of the article was "The Role of Echocardiography in Cost-Effective Health Care." This was the latest in a series of reports submitted to my editorial office with the phrase "cost-effective health care." It is evidently fashionable to scrutinize current diagnostic and therapeutic modalities for their "cost-effectiveness." Is this recent fad simply a rush to use an eye-catching phrase (such as the sadly overused word parameters), or does it portend an orientation toward new priorities in the management of patients?

I submit that a cost-effective approach may be appropriate for office management or industrial technology, but it is unacceptable when applied to patient care. If the clinician makes his therapeutic decisions on the basis of "the most cost-effective" drug or medical device, is the patient aware that he or she may be receiving second-rate medical care? Informed consent has become a moral and legal necessity. This process of self-determination . . . [Full Text PDF of this Article]

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