Like all physicians, my judgments are subject to error. However, I do feel I am able to use the resources of my profession in a fairly effective and cost-efficient way. Having said that, let me illustrate a "bad judgment/bad outcome" scenario that is becoming all too common in the health care field.

Every Wednesday I see patients at a low-income clinic in the Salt Lake Valley. The patients of this facility have little or no financial resources to pay for the "usual" medical care. I recently saw a Latina woman who came to our clinic complaining of upper back pain. She had been seen a few days earlier at a local emergency room. She walked out of the ER with no definitive diagnosis, unresolved back pain, and much poorer.

While at the ER she had a chest X-ray, CT scan of her cervical spine, X-ray of her shoulder (the one nearest the pain), CT lung scan and blood tests. She was told she had a muscular problem and was given some pain medication.

After talking with her and examining the appropriate anatomy, I found a localized spot on the medial border of her scapula. I actually examined her, something I would expect of most physicians, and felt an injection of Lidocaine and cortisone would help. As you might expect, or I wouldn't have shared this with you, she walked out of our clinic pain­ free and at a minimal cost of treatment.

Unfortunately, she will either have to take out bankruptcy or the hospital will have to write off the ER charges, not to mention the four or five days of continued pain, which could, and should, have been resolved on her first visit to the ER.

We can, and must, do better as a health care industry. The costs to society and the individual have become unacceptable.

Maurice Baker, Murray