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John M. Eisenberg, MD

JAMA. 1999;282:1865-1869.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Soon after Rene Laennec invented the stethoscope in 1816, it was met with "suspicion and distrust . . . by those who were practicing medicine when it was introduced."¹ As late as the 1850s, skeptics described the new diagnostic aid as "a dangerous instrument."¹

While most agree that health care technology has advanced physicians' ability to improve their patients' health and quality of life, there has been considerable disagreement about which technologies to use, how much is too much, and whether the technologies clinicians use are providing value for the money spent. In 1827, a commentator on the stethoscope wrote, "The extent of its usefulness is, as yet, far from being ascertained,"¹ and most new technologies since then have been greeted by similar initial doubts.

These questions are particularly relevant today, in a US health care system dominated by intense competition among clinicians and organizations vying . . . [Full Text of this Article]

Innovation and Flexibility Should Guide Assessment

Author Affiliation: Agency for Health Care Policy and Research, US Department of Health and Human Services, Rockville, Md.

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