Early Office-Based vs Late Hospital-Based Nasolacrimal Duct Probing

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Abstract
Because the public bears such a large percentage of health care costs, physicians are coming under increasing pressure to provide care that is not only skilled and compassionate but also cost-effective. Out-come analysis and cost-benefit ratios are buzzwords of the 1990s. In this issue of the Archives, Kassoff and Meyer1 have addressed the issue of cost-effectiveness in the management of congenital nasolacrimal duct obstruction using a technique called clinical decision analysis and have provided us with important and useful information. They have concluded that early office-based probing is substantially more cost-effective than a later, hospital-based procedure. Although cost is an important consideration for decision making by patients and physicians, other factors that I will discuss below need to be part of the equation. To paraphrase the noted physicist, Nehls Bohr, "The opposite of a false statement is a true statement, but the opposite of a true statement may be

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