The organizational structure and function of our medical system are rooted in fundamental changes made at the beginning of the 20th century that emphasized an acute care approach and marginalized prevention and public health. With the aging of the population, the shift in the burden of disease toward chronic conditions has accelerated such as asthma, COPD, diabetes, HTN. Changing the system requires recognition of these cultural, technological, and economic obstacles and identification of specific means for overcoming them through alterations in medical education, medical research, health policy, and reimbursement.
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