W. Bruce Fye

"Why is a book that weaves together histories of heart care, a celebrated medical center, and specialization important? And why should it interest general readers as well as health care professionals, historians, social scientists, and policymakers? First of all, most individuals living in industrial countries have or will develop cardiovascular disease during their lifetimes. And most of them have already seen coronary heart disease alter or end the lives of family members and friends. Despite astonishing developments in diagnosis and treatment in recent decades, cardiovascular disease still kills more Americans than any other cause. Its economic implications are staggering. In the United States alone, medical costs and productivity losses related to cardiovascular disease are approaching $500 billion annually. ... Second, the Mayo Clinic is the worlds oldest and largest multispeciality group practice. There is value in understanding why this institution has been a national leader in health care since the early twentieth century. ... Specialization is the books third major topic. I agree with historian s assertion that "specialization is the fundamental theme for the organization of medicine in the twentieth century." ..."

"is an impatient industry, especially when Wall Street is involved. Healthcare professionals must be sure that aggressive strategies to cut costs and enhance short-term profits do not harm patients. We face special challenges when new policies are implemented abruptly. For example, a managed care company in Wisconsin gave hospitals less than 2 months’ notice in 1994 that they would routinely authorize just 5 days of hospitalization for patients undergoing CABG despite the fact that fewer than 9% of patients in the state were achieving this target at the time."

"The history of medicine serves several useful functions today, when doctors and the American health care system confront many challenges. Physicians live and work in an era of escalating expectations, eroding autonomy, and decreasing discretionary time. There is so much—far too much—to know, to learn, and to do. Understandably, many doctors are concerned about the future of medicine as they watch so many powerful political, economic, and social forces transform medical practice, research, and education. In this context, the history of medicine provides useful perspective and teaches valuable lessons. Just as a helps us assess the significance of their symptoms and develop a diagnostic and therapeutic strategy, the history of medicine provides important perspective on present and future challenges and opportunities. ... History also teaches humility. I could cite many examples that apply to institutions, organizations, nations, and entire cultures, but I will focus on humility at the level of the individual. The aphorism “fame is fleeting” applies to medicine, as it does to any other area of human endeavor. Almost all of the most influential physicians and medical scientists of earlier generations are now forgotten. ..."