But often we are too far removed from the actual money exchanging hands to see the necessity in practicing cost-effective medicine.

In addition to being removed from the impact of care costs, we are far too removed from the other 'costs' of tests—time, pain, and sequelae (i.e.—additional testing, scarring, stress, etc). For most of us, it is a simple checkbox on a screen. I think we need to be periodically reminded of all costs, not just financial ones. And I agree with Dr Rikin, we constantly need to ask ourselves, 'What is the one best test?'