Stanley Feld MD,FACP,MACE
In the late 1950’s and early 1960 pace of medical bench research and clinical research accelerated. The government invested heavily in an effort to increase medical knowledge. Medical schools expanded. The medical schools increase medical student and Phd. enrollment. Medical schools became medical research factories. The era has been referred to by some as the Golden Era in Medical Research
The medical knowledge base was growing at the rate of 10% per year. The growth of medical knowledge resulted in a growth of subspecialties in medicine and surgery. There simply was too new much medical information growing at a very rapid rate. The rate of growth of medical information and procedures were too much for a generalist to master.
These advances improved the quality of medical care for acute illness. It expanded our ability to “fix things that were broken.” We were able to save patients from death in a very skilled way. The survival rate for cancer improved markedly. Specialties such as Oncology, Pulmonology, Endocrinology, Cardiology, Gastroenterology to name a few grew rapidly. In turn, the cost of this specialized care produced accelerating cost of medical care. Patients stayed alive longer. Diseases were cured or stabilized. Our ability to help people medically was much more effective than after WWII.
By early 1980, Medicare’s burdens for medical costs were out of control as the population aged and treatment were improved. The government said: “ Stop! We can not pay the fees we have been paying. We have to have cost reductions and controls“
This generated to the next problem for the health care system.