New York, NY, March 8, 2011 As the debate about healthcare in the United States rages, four insightful articles in the March 2011 issue of The American Journal of Medicine strive to add reasoned arguments and empirical research findings to the dialog.
The issue leads off with the editorial, "The 800-Pound Gorilla in the Healthcare Living Room," by Journal Editor-in-Chief Dr. Joseph Alpert, Professor of Medicine, Arizona College of Medicine, Tucson. As a practicing physician and medical educator, Dr. Alpert has first-hand experience with the current environment of medical treatment. In his view, "the most important deficit in our new healthcare legislation was the failure to address the 800-pound gorilla sitting squarely in the middle of the US healthcare system: the need for tort reform." He contrasts his own training at Harvard Medical School, where the rule for good patient care was "Don't order any test or intervention (medical or surgical) that has little or no chance of improving the patient's quality or length of life" against the current rule: "Order a huge array of tests, including radiographic imaging, to rule out every conceivable clinical condition including very unlikely diagnostic entities." Without meaningful reform to stem the tide of defensive medicine with its staggering volumes of unnecessary diagnostic testing, he believes that all attempts at controlling healthcare costs in the US will be doomed to failure.
In "On the Critical List: The US Institution of Medicine" authors Salinder Supri, PhD, nderung Consulting, New York, NY, and Karen Malone, MA, University of Medicine and Dentistry of New Jersey, Newark, NJ, examine the US institution of medicine. They characterize it not as a single, comprehensive and cohesive system of healthcare, but instead, as a myriad of large and powerful organizations including insurance companies, Health Maintenance Organizations (HMOs), corporate for-profit hospital chains, and pharmaceu
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