Drawbacks and limitations of computed tomography.

To the Editor: The observations by Dr. Fred (Tex Heart Inst J 2004: 31:345–8)1 are on the mark and long overdue. I would like to add 2 points: First, Dr. Fred was probably reluctant to generalize his observations; however, the same issues exist in cardiology and most other fields of medicine. Plainly, medicine today is technology driven and has lost its clinical focus. Second, we have legal reservations about failing to practice the “standard of care,” i.e., technology-driven medicine that we (not the legal profession) created in the first place. Degradation of the practice of medicine aside, this approach is driving us (for example, Medicare) to the poorhouse. David L. Lubell, MD Division of Cardiology, Mt. Sinai Hospital Medical Center, Chicago