We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

To the Editor.—

Joan N. Berzoff, EdD; Lewis M. Cohen, MD
Arch Intern Med. 1986;146(7):1448. doi:10.1001/archinte.1986.00360190240039.
Text Size: A A A
Published online


—In the January 1986 issue of the Archives, Smith et al1 presented data obtained from a group of patients with somatization disorder. In a recent paper,2 we described one of our patients who had incurred $46,000 in medical charges in a single year, and whose estimated lifetime medical bills totaled one-half million dollars. We documented that this 39-year-old patient had undergone at least 82 operative and invasive diagnostic procedures, as well as 54 admissions and 66 emergency room visits at eight separate hospitals. Having experienced the incredibly time-consuming work involved in tracing the patient's medical care, and having unsuccessfully attempted to forestall yet another surgery, we would like to comment on Smith and co-workers' study.

We appreciate the Promethean labor involved in gathering data on 41 patients, but question the methodology. Smith and co-workers performed formal interviews, calculated health care charges, and had their subjects complete the Rand


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.