Should doctors cut costs at the bedside?

KIE: Two physicians debate whether doctors should be expected to ration the care they give individual patients in the interest of controlling health expenditures. Dyer rejects the notion that physicians should serve as society's agents in reducing medical costs. He emphasizes that doctors' primary obligations are to their patients and warns that, by assuming the responsibility for cost control, physicians risk a conflict of interest that could harm the physician patient relationship. Brazil argues that cost-consciousness and quality medical care are compatible. He cites examples from a variety of settings to contend that attention to costs on the part of physicians can result in more humane, effective medicine.^ieng