Golden Age of Medical Science and the Dark Age of Healthcare Delivery : Reflections on the Practice and Art of Medicine

by Weinberg, Sylvan Lee, M.D.

• ISBN13: 9780914783909
• ISBN10: 0914783904
• Edition: 1st
• Format: Hardcover
• Copyright: 2000-01-01
• Publisher: CHARLES PRESS PUBLISHERS

Summary

(The American College of Cardiology) Wright State Univ., Dayton, OH. A collection of essays from the American College of Cardiology's monthly international audio journal, ACCEL. Articles were written by Weinberg between 1989 and June 2000 during he 15-year term as editor-in-chief. Commentaries explore victories, failures, and the direction of future implications.

Table of Contents

Forbidden Knowledge and the Cloning of a Lamb	1	(4)
Genetic Treatment and Enhancement: Prospects Bring Controversy	5	(4)
On Time to Heal: Observations and a Review	9	(5)
The Uncertainty Principle: From Quantum Mechanics to Medical Education and Practice	14	(3)
The American College of Cardiology at 50	17	(4)
At the 50th Anniversary of the Irish Cardiac Society: Remembering the Dublin School	21	(4)
The Quest for Medical Certainty	25	(4)
Streptomycin Treatment of Pulmonary Tuberculosis: The Classic Randomized Trial Turns 50	29	(5)
Meta---Analysis Under Analysis	34	(4)
Evidence---Based Medicine: A Clinical Critique	38	(3)
Guidelines and Intuition: Counterpoints in the Art of Medicine	41	(4)
The Trouble with ``Appropriateness''	45	(3)
The Tyranny of ``Value---Neutral Cold Statistics'' in Government and Medicine	48	(4)
Epidemiology at Risk? Or is it the Public?	52	(4)
Medicine Between Two Worlds: Modern and Post---Modern	56	(3)
Alternative Medicine: A Flight from Science and Reason	59	(4)
The Clinton Plan and American Healthcare in Transition	63	(3)
Medical Autonomy and Professionalism in Medicine: Can Their Decline Be Reversed?	66	(2)
Ethics in Cardiovascular Medicine: The 29th American College of Cardiology Bethesda Conference	68	(4)
The AMA and the U.S. Congress: Responding to the Tyranny of the HMO---Insurance Complex	72	(4)
Managing the Excesses of Managed Care: The Courts or the Congress?	76	(3)
An American Obsession: Minimize Hospitalization and Length of Stay	79	(4)
Three---Day Post-MI Hospital Stay: How Safe, Which Patient, Who Decides and on What Evidence?	83	(4)
On the Continuning Cholesterol Controversy	87	(3)
The Imperative for Lipid Lowering in the Treatment of Coronary Artery Disease	90	(3)
The Cholesterol Wars Resume: Whither Guidelines?	93	(4)
Aggressive Lipid Lowering----Still Not Aggressively Prescribed	97	(3)
Liquid Modification for Control of Atherothrombosis	100	(4)
Cardiovascular Therapeutic Thresholds and Absolute Risk Projection	104	(4)
Prevention Paradox	108	(2)
Observations on the Enigma of Sudden Cardiac Death	110	(3)
New Medicine from Old: Hirudin and the Leech	113	(3)
Anticoagulation Therapy After Myocardial Infarction: The More Things Change	116	(4)
Coronary Angiography: Controversy Over Indications	120	(4)
On the Virtues of a Normal Coronary Angiogram: Clinical and Economic	124	(3)
Toward a Definition of Myocardial Ischemia	127	(2)
Inflammation, Infection and Acute Coronary Disease	129	(4)
Type II Diabetes, Coronary Artery Disease and Hypoglycemic Agents, Revisited	133	(4)
Treatment of Hypertension: A Metaphor for Medicine---Advanced Looking Backward, Primitive Looking Forward	137	(4)
A Spectrum of Clinical Judgments: A Patient with Stroke and Unstable Angina	141	(4)
Myocardial Revascularization: A Time of Change and Controversy	145	(5)
The Twilight of Coronary Disease?	150	(4)
Heart Rate and Longevity: Their Relationship and Clinical Implications	154	(3)
Apoptosis---the Good and the Bad: Possible Future Therapeutic Implications	157	(3)
On the Future of Cardiovascular Medicine and Research in the Molecular Era	160	(4)
Culture and American Medicine: Puritanism, Enlightenment and the American Frontier	164	(3)
Remembering Irvine Page	167	(2)
The Propriety of Promotional Marketing of Technologies in Progress	169	(2)
Industry, Academia and the Medical Literature	171	(4)
The Media and Managed Care	175	(4)
Scientific Journalism in the Marketplace	179	(5)
Reflections on Advocacy: Ethics and Limits	184