The creative and innovative ethic of American medicine is legend and has contributed fundamentally to the breadth, depth, and pace of advances in our capacity for diagnosis and treatment of disease and injury. Indeed, the number of new pharmaceuticals, biologics, medical devices, and healthcare services introduced into American healthcare settings and marketplaces substantially exceeds the capacity to know the circumstances under which a particular intervention is best applied. The consequences of this gap between assessment capacity and available services include increasing uncertainty about what constitutes “best care,” a steady expansion in the national and personal cost of medical care, and a substantial growth in concern and distrust among physicians and.
