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Ann Thorac Surg 1986;42:124-133
© 1986 The Society of Thoracic Surgeons

Articles

The Thoracic Surgical Industrial Complex

Albert Starr, M.D.*

Division of Cardiopulmonary Surgery, Oregon Health Sciences University, and The Heart Institute at St. Vincent Hospital and Medical Center, Portland, OR 97225

* Address reprint requests to Dr. Starr, 3181 SW Sam Jackson Park Rd, Portland, OR 97201

The thoracic surgical industrial complex is an industry worth $2 billion per year and is shaped by six dominant forces, three positive and three negative. The three positive forces are technological innovation, entrepreneurial activity, and the flow of capital and the three opposing forces, government regulation, cost-containment, and the excessive costs of product liability insurance. We are now at a critical time in the evolution of this industry, with growth being enhanced in areas of lesser risk, namely, nonimplantable devices, at the expense of high-risk implantable devices. The future of the artificial heart hinges on the balance between the six forces, and this analysis examines the possibilities for timely development of this ultimate implantable device.




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