Cost effectiveness in an internal medicine residency program: one physician's approach.

The impact of a cost-effectiveness program on an internal medicine service in a teaching hospital has been assessed. Notable reductions were made by the study service as compared to the control services. Period of hospitalization, number and cost of laboratory tests, charges for medication, number and cost of radiologic examinations, and overall costs of hospitalization were importantly reduced. Methods used to effect this reduction included distribution of a cost booklet, daily patient chart review, use of itemized patient bills, elimination of routine admission tests and standing orders, and use of a "why' philosophy instead of a "why not' philosophy.