In order to determine the health effects of an intervention that reduces the cost of care for somatization disorder (SD) patients, 59 primary care physicians were randomized to receive a psychiatric consultation letter providing treatment recommendations for 73 patients either at baseline or the end of the year-long study. Seventy of these patients (96%) were followed every 4 months for 1 year by a research assistant blind to randomization. A year following the intervention, patients of experimental physicians reported greater physical capacity than patients of control physicians (mean difference = 17.9, 95% CI 1.0-34.9) with a $466 reduction (95% CI $132-$699) in health care charges. In addition to a net 21% reduction in health care charges for the typical SD patient, the consultation letter improved physical functioning in a group of highly impaired subjects.