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Editorial |

Isotretinoin Laboratory Test Monitoring—A Call to Decrease Testing in an Era of High-Value, Cost-Conscious Care

Kanade Shinkai, MD, PhD1; Amy McMichael, MD2; Eleni Linos, MD, MPH, DrPH1
[+] Author Affiliations
1Department of Dermatology, University of California San Francisco
2Department of Dermatology, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina
JAMA Dermatol. 2016;152(1):17-19. doi:10.1001/jamadermatol.2015.3128.
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Health care costs are increasing faster in the United States than in any other industrialized nation, with estimates of low-value services—services that can be eliminated without adversely affecting patient care—composing up to 30% of health care spending.1,2(pp65-108)3 Consistent with the Physician Charter on Medical Professionalism, physicians have a responsibility to balance individual patient needs with “care that is based on the wise and cost-effective management of limited clinical resources,” including “scrupulous avoidance of superfluous tests.”3(p245) Specialty-specific efforts are critical to identifying the relevant areas where cost-effective treatment can be delivered in balance with quality and efficiency; dermatologists have begun to join the national efforts toward this end.4,5 In this issue of JAMA Dermatology, Lee and colleagues6 present their contribution in assessing laboratory test monitoring during isotretinoin therapy for acne, much-needed work to create a strong foundation of information on which to establish clear recommendations for safe, high-value, cost-conscious care within our specialty practice.

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