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Editorials

Cardiothoracic surgery: time for reappraisal!

Heidelberg University, Heart Surgery, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany

Received 24 January 2008; accepted 28 January 2008.

^_* Corresponding author. Tel.: +49 8151 9717383; fax: +49 8151 9718160. (Email: siegfried.hagl@hagl-online.com).

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

Today I would like to reflect, sine ira et studio, about the status of cardiothoracic surgery by critically asking what has changed during the past decades. I shall conclude with some suggestions as to how we might adapt to these changes in order to carry forward the remarkable development of our speciality and to retain its attractiveness for those who follow in our footsteps.

First, I shall comment about the environment in which we work and the expectations and demands medicine in general is facing. One need only to read current newspapers to recognize that there is ever growing public opinion expressing the belief that health care is too expensive and yet not meeting the needs of patients. The exponential increase of health care costs largely started in the 1990s, although it could be argued that it actually began earlier and merely came to widespread public attention at that time.

In the 1990s, politicians and insurance companies began a concerted campaign to control the entire health care system, largely by confronting the medical community with reproach. They alleged that doctors were self-serving and greedy.

Concurrently new tools, such as the Internet, increased public awareness and superficial knowledge about medicine and health care. With enormous rapidity, medicine seemed to become what might be called ‘everybody's competence.’ A ‘know-it-all’ attitude, that included criticism and scepticism about research, developed at a time when the health of many was threatened by the emergence of new and dangerous diseases such as AIDS. It was not surprising that the public vigorously demanded immediate solutions, meanwhile blaming the scientific research community for being unprepared and lethargic.

From this series of events, one realizes that our professional criteria of success and the public's criteria of success are often not the same. How can we explain this dichotomy? Society . . . [Full Text of this Article]