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July 28, 2010

Medical Leadership in an Increasingly Complex World

Author Affiliations

Author Affiliation: RAND Health, Santa Monica, California.

JAMA. 2010;304(4):465-466. doi:10.1001/jama.2010.1049

Greece is going bankrupt. The euro is shaky. The oil inundating the Gulf Coast may eliminate one-third of the US seafood catch. In the midst of this chaos, the nightly news focuses on a medical breakthrough. At a cost of about $100 000, a man with metastatic prostate cancer can be treated with an infusion of his own cells and live, on average, a few months longer.1 The commentator questions whether insurance companies will pay for this therapy and wonders whether men who do not have metastatic cancer will demand access to the therapy, even if they have to pay for it themselves. Perhaps Yeats was right—“Things fall apart; the centre cannot hold.”2