Teaching Technologic Restraint

Abstract

An excessive number of serum determinations of vitamin B-12 and fohc acid was being ordered from the Medical Service. During 1976 the estimated laboratory costs for detecting five cases of pernicious ane mia were about $45,000 or $9,000 per case. It was felt that an educational program stressing the limitations of this use of the laboratory, the cost of the strategies in use, and the proposal of alternate, less costly strategies might lead to a reductm in utihzation of the laboratory. It has been the feeling that voluntary technologic restraint could not be practiced by physicians and that economic rationing might become necessary to control costs. It was found that physicians could be taught restraint but that constant reinforcement and emphasis would be necessary to make voluntary technologic restraint useful. Monitor ing use of the clinical laboratory is a useful technique for assessing the effectiveness of programs aimed at cost containment.