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Changing Physician PSA Ordering Patterns Through Education

Nadine K. Skelton, MD; William P. Skelton III, MD
Arch Intern Med. 1994;154(7):819-820. doi:10.1001/archinte.1994.00420070149021.
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Dramatic changes in the practice of American medicine have occurred within the past decade. The advent of diagnosis-related groups, health maintenance organizations, and preferred provider organizations have all but abolished the once supreme authority of the private practitioner to practice as he/she once saw fit. Add to this the explosion of malpractice claims and the greater sophistication of the lay public in matters of their own health, and it is little wonder the physician may feel that he/she is being forced to order tests whose results may be unwarranted, useless, or provide ambiguous data. The prostate-specific antigen (PSA) test is one in the latter category. Prostate cancer is the number two killer from cancer for men in the United States. It reached its peak in the mid-1930s at approximately 35 000 deaths per year and has remained constant at that level through today. Despite many advances in the field of


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