Russek Lecture. Must cardiology lose its heart?

Regulations and restrictions imposed by external agencies are forcing cardiologists into an unnatural self-protective and defensive posture against their patients. The key to breaking the pattern of mutual skepticism and mistrust lies in returning the focus to its rightful place: the patients' needs. Thus, payment systems must be devised that reward cognitive skills, time spent with patients and continuity of care as they reward technologic interventions and procedures. In advocating necessary changes in the system, only physicians themselves can provide a convincing voice in the political arena. They must look beyond their own self-interest to recapture the moral and ethical high ground where the best care of their patients and their own professional satisfaction stand side by side.