Edward arrived at the hospital following a stroke; a standard work-up failed to reveal an obvious cause. His physician explained that a previously diagnosed patent foramen ovale (PFO), a hole in between the chambers of his heart, may have led to his stroke. He presented three possible treatment options to Edward: (1) medical management with drugs; (2) open surgery to correct the defect; or (3) interventional catheterization to correct the ...

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The physicians role in cost containment is absent during training After graduating from college I had the opportunity to spend two years working at the Institute of Medicine on a variety of health care improvement topics. When it came time to apply to medical school I noticed an odd dissonance—the challenges I had been grappling with at the IOM were not manifest in most medical school curricula. I knew that multidisciplinary teams ...

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