When I was a medical student, a common debate among us was, “Is medicine a science
or an art?” The more enlightened of us thought it a combination of the two; unfortunately,
we were wrong. Medicine is a business. Although there may be some scientific basis
for what we do and a lot of art in the practice of medicine, the bottom line is what
rules. The days of admitting patients to the hospital for a week to rule out a myocardial
infarction (MI) are long gone. Hospital administrators are pushing for shorter and
shorter stays, regardless of whether we make the diagnosis, educate the patient, or
begin therapy. Modern technology has replaced experience and gestalt. Missed MI accounts
for the single highest malpractice award; every juror knows that chest pain equals
MI. The population is aging, people are more obese, glucose and cholesterol are rising,
coronary arteries are closing, emergency departments (EDs) are filling up, and people
are dying.
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Article info
Publication history
Published online: June 25, 2010
Identification
Copyright
© 2010 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
