Medical costs crisis: Part 2. How to regain control while retaining quality of care

Physicians often are singled out as major culprits in driving up the cost of health care, principally because of our role in ordering tests and in employing technologically advanced diagnostic procedures. In fact, these activities play a much smaller part in cost increases than has been thought. The forces actually responsible are the fundamental medical decisions we make on hospitalization, major surgery, intensive care, and the like. Tighter control of these decisions, which have so altered the dimensions of medical care costs, call for reexamination of our basic uses of medical manpower as well as better allocation of our technologic and physical resources.