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Invited Critique |

Modern Day Bloodletting: Is That Laboratory Test Necessary?  Comment on “Surgical Vampires and Rising Health Care Expenditure”

A. Benedict Cosimi, MD
Arch Surg. 2011;146(5):527. doi:10.1001/archsurg.2011.104.
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The practice by surgeons of bloodletting or phlebotomy to “rebalance the body's humors” dates back to at least Egyptian times. Some have speculated that not even George Washington was spared, having been bled to death by the lancets and leeches of his aggressive doctors. Fortunately, the practice was abandoned in the late 19th century, when it was finally accepted to have no medical benefit. Today, therefore, the term phlebotomy usually refers to the drawing of blood for diagnostic rather than therapeutic purposes. Unfortunately, the pervasive, unnecessary testing that is currently ordered, particularly in our teaching hospitals, sometimes rivals the volumes prescribed by our bloodletting ancestors. These wasteful habits raise major economic issues.

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