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    Doctors must lead in stemming rise in health care costs

    RE “Medicare payment changes draw fire” (Page A1, Nov. 26): The outcry from specialists over changes to Medicare payments is the inevitable result of decades in which physicians failed to acknowledge the crisis in rising medical care costs and participate in solving it.

    Physicians control medical care costs by ordering evaluation, treatment, and surgical and other procedures for their patients. They also play a key role in managing expensive hospital stays, either as primary care doctors, hospitalists, or specialists.

    The dramatic growth in medical care costs has continued for more than 40 years, while the aging of the baby boom generation loomed as an additional burden on an inefficient medical care system. While physicians zealously protect their authority to make professional judgments for the care of their individual patients, as a group they have shirked their responsibility for developing thoughtful solutions.


    Private insurers and government agencies are now forced to impose constraints on medical care practices and costs because we simply cannot afford the current payment arrangements, which raise costs while having uneven impacts on quality of care. Physicians are the gatekeepers for medical care costs and best practices, and they must now take on an organized role in improving quality of care while reducing costs.

    Louise Venden


    The writer served on a task force that reorganized Wisconsin health and human services in the late 1970s.