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Article
June 23, 1989

The Vascular War

Author Affiliations

St Elizabeth's Hospital of Boston Tufts University School of Medicine Boston, Mass

St Elizabeth's Hospital of Boston Tufts University School of Medicine Boston, Mass

JAMA. 1989;261(24):3550. doi:10.1001/jama.1989.03420240064019
Abstract

To the Editor.—  The article by Wexler et al entitled "The Vascular War of 1988"1 and the accompanying commentary by Dr Zarins2 call attention to an important problem that affects not only certain subspecialty practices, but, more important, patient welfare and medical costs. Wexler et al have made a forthright proposal to resolve the "turf battle" among vascular surgeons, radiologists, and cardiologists competing for rights to perform balloon or laser angioplasty or other new transluminal interventions. Their establishment of a Center for Interventional Vascular Therapies at the Stanford (Calif) University Medical Center should help arbitrate the conflicts. However, it skirts a more profound issue.Beyond the turf battle and who wins it lies the fundamental question of how to establish the indications for these new, appealing, and expensive interventions. This objective may not be met by the competing specialties themselves because of a conflict of interests. In view

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