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Steven H. Woolf, MD, MPH

JAMA. 2007;297:523-526.

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

To maximize the health of its citizens, society should pursue interventions in proportion to the ability of those interventions to improve outcomes. All else being equal, a strategy that is more effective than its alternative should receive more, not less, attention. Doing otherwise can compromise the health of patients. For example, if intervention A is 10 times more effective than intervention B in reducing mortality, performing more of B than A will allow more deaths to occur. Just as errors of omission cause harm, inattention to how priorities are balanced can indirectly claim lives, contribute to disease, and generate costs that would not occur if priorities were in greater harmony with potential gains.

The "silo" mentality that pervades so much of clinical practice and policy in the United States often finds decision makers focusing their attention and resources on a specific patient or disease—any one . . . [Full Text of this Article]

Choosing Effective Services

Author Affiliations: Departments of Family Medicine, Epidemiology, and Community Health, Virginia Commonwealth University, Richmond.

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