To the Editor.
—The editorial by Dr. Laszlo, "Automated Chemistries" (Arch Intern Med 133:1068-1069, 1974), overadequately voices two plaints. The first is the lack of cost effectiveness consideration when ordering or instituting multiphasic tests. Too little attention is generally paid to cost effectiveness in all of medicine, not only in the laboratory. Cost effectiveness studies are often available but are open to debate until we find the ultimate price that society will pay to alleviate suffering or to save lives.The second plaint, which forms the basis of most of the editorial, is deplorable since it stems from a lack of rapport between the physicians who are directly involved with patient care and the physicians in the laboratory. When a clinician feels free to ask the laboratory to set up a new test, or to churn out the numbers needed for a paper, the laboratory should, and, I believe, in