Opportunities for the cost reduction of medical care.

The explosion of medical knowledge has deluged the medical community with a plethora of new medicines, new tests, and new procedures. This creates a serious need to carefully evaluate the definable benefits from these new developments, which promise to increase the quality of medical care beyond older, established, and usually less-costly methods. In addition, more recent information has clearly identified genetic variation in an individual's response to medications. As such, conventional wisdom may now prove to be wrong or subject to question. Examples of this, which we present, include situations where medication may more safely provide benefits to asymptomatic, stable patients than surgical interventions with high potential for complications that counteract predicted benefits. We argue that preventive medicine offers an unusual and comprehensive promise of disease prevention and treatment. The issues we cite may be effective in the future cost reduction of medical care.