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Presidential Address

Is There a Role for the Medical Profession in Solving the Problems of the American Health Care System?

Department of Cardiovascular Surgery, Children's Hospital, Harvard Medical School, Boston, Massachusetts

^_* Address correspondence to Dr Mayer Jr, Children's Hospital, Harvard Medical School, 300 Longwood Ave, Boston, MA 02115 (Email: john.mayer@cardio.chboston.org).

The first 300 words of the full text of this article appear below.

This year has been an important one in many ways for The Society of Thoracic Surgeons (STS), with many challenges and opportunities. Throughout this year, I have tried to view every issue from the perspective of what will be good for our patients and what will be good for our profession. I want to emphasize that word "profession," a common heritage that binds all of us together, but a concept that is incompletely understood and easily forgotten in the atmosphere of the financial and societal pressures in which American medicine now finds itself. I would like to focus on what it means to be a member of the medical profession and to provide a conceptual framework from which to understand some of the challenges and concerns we all have. From this perspective, I believe some solutions to the problems we face can emerge. Although much of this discussion will deal with the American health care system, I hope that those from other countries will find principles that are relevant for your health care systems.

In preparing this address, I reviewed the STS presidential addresses for the last 10 years. I found it interesting that the issues George Kaiser [1] thought we were facing in 1998 are not very different from those we face today, issues of regulation and loss of autonomy and control over how patients are cared for, external scrutiny and accountability, funding issues and the costs of health care, and new technology and therapies and their implications for surgical practice. The titles of several popular books from that time frame are of interest: Why We Spend Too Much on Health Care and What We Can Do About It [2], Medicine at the Crossroads: The Crisis in Health Care [3], and Strong Medicine: . . . [Full Text of this Article]

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