▁management ▁( util ization ▁review ) ▁has ▁evol ved ▁over ▁dec ades ▁among ▁both ▁public ▁and ▁private ▁pay ers ▁in ▁an ▁attempt ▁to ▁reduce ▁over use . ▁In ▁this ▁effort , ▁ins ur ers ▁employ ▁phys icians ▁to ▁review ▁the ▁actions ▁of ▁other ▁phys icians ▁and ▁detect ▁over use . ▁Util ization ▁review ▁has ▁a ▁poor ▁reputation ▁among ▁most ▁clin icians ▁as ▁a ▁cor rupted ▁system ▁in ▁which ▁util ization ▁review ers ▁have ▁their ▁own ▁per verse ▁in cent ives ▁( i . e ., ▁find ▁ways ▁to ▁den y ▁coverage ▁no ▁matter ▁what ) ▁and ▁in ▁some ▁cases ▁are ▁not ▁pract icing ▁phys icians , ▁lack ing ▁real - world ▁clin ical ▁insight ▁or ▁wisdom . ▁ ▁The ▁ 2 0 1 0 ▁U . S . ▁health ▁care ▁reform , ▁the ▁Pat ient ▁Prote ction ▁and ▁Aff ord able ▁Care ▁Act , ▁did ▁not ▁contain ▁serious ▁strateg ies ▁to ▁reduce ▁over use ; ▁" the ▁public ▁has ▁made ▁it ▁clear ▁that ▁it ▁does ▁not ▁want ▁to ▁be ▁told ▁what ▁medical ▁care ▁it ▁can ▁and ▁cannot ▁have ." ▁U we ▁Rein hardt , ▁a ▁health ▁econom ist ▁at ▁Pr inc eton , ▁said ▁" the ▁minute ▁you ▁attack ▁over util ization , ▁you ▁will ▁be ▁called ▁a ▁Naz i ▁before ▁the ▁day ▁is ▁out ". ▁ ▁Professional ▁soci eties ▁and ▁other ▁groups ▁have ▁begun ▁to ▁push ▁for ▁policy ▁changes ▁that ▁would ▁encou rage ▁clin icians ▁to ▁avoid ▁providing ▁unnecessary ▁care . ▁Most ▁phys icians ▁accept ▁that ▁labor atory ▁tests ▁are ▁over used