The diminishing returns of modern medicine

The New York Times, March 21, 2014

For several decades, doctors have taken it as an article of faith that more rapid treatment of an acute heart attack improves patient survival. The treatment of choice today is angioplasty, where tiny balloons and wire-mesh cylinders called stents are used to open up blockages in the arteries that feed the heart. A "door to balloon," or D2B, time – the period from a patient's arrival in the hospital to inflation of the coronary balloon – of less than 90 minutes has become a quality metric for American hospitals. "Time is muscle" is the operative mantra, and the shorter the delay, the better.


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