HealthManagement, Volume 2 - Issue 1, Spring 2008
Dear Readers,
Medical science in practice has always been closely dependent on
prevailing economic, social, and cultural conditions. This was true in ancient
times and has remained true until the present day. Never before, though, has
that science shown such rapid advances, while at the same time being so
crucially tied to costs, priorities, and political choices. Inevitably,
therefore, the rational management of healthcare services has become a goal of
major importance.
Management itself, in theory and in practice, has a
multi-factorial character, in which many, often disparate, components act
synergistically towards the realisation of a strategic objective. When the
latter is healthcare—whether it be prevention or the treatment of disease—it is
evident that management plays a much more complex role and that managers must
combine fiscal rationality with the higher value represented by the uniqueness
of each individual life.
Indeed, Hippocratic medicine lays down the non-negotiable
principle that the physician must constantly and unswervingly choose what is
best for the patient. Fortunately, this premise continues to hold sway as a
central perception in the philosophical core of modern medicine and to oversee
the swearing in of new doctors all around the world. Its official repudiation,
even in a limited way, would have huge repercussions with respect to the
anthropocentric focus that our civilisations and religions have maintained for
centuries.
However, the idealistic Hippocratic approach has recently fallen
on hard times, in the light of the reality imposed by the increase in
healthcare costs. Medicine has long since ceased to be a game of solitaire and
has become a multi-player game in which other participants, not the physician,
may shuffle, deal, and set trumps. The complexity of the factors that determine
costs, the questioning of the result of each and every priority within the
sphere of healthcare, have created a need for rational management. The task
sounds reasonable, even easy; but it is not. If the financial management of
healthcare and the priorities for human and economic resources were the simple
result of logic, there would not be so many alterations, altercations,
publications, and not infrequently, calamities.
This Journal will be published quarterly, with a well-defined
purpose: to present, primarily to cardiologists and secondarily to hospital
managers, a spectrum of topics related to evidence based cardiology, such as
guidelines, the affordability to caregivers of their implementation, patients’
access to medical technologies, management of available resources, and of
course, matters pertaining to daily nosocomial reality.
Cardiovascular medicine has had many successes in recent years,
but there are also practical necessities. One voice, we hope a strong one, from
this publication can surely make a positive contribution to the rationality of
all kinds of decision making. In this effort it is our hope and wish that we
will have your support.
Yours faithfully,
Panos E. Vardas,
MD, PhD Professor
of Cardiology