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Concepts of the President's Commission
on Heart Disease, Cancer,and Stroke

Michael E, De Bakey, M.D.

Reprinted from:
Clinical Research
Vol. XIII, No. 2
April, 1965
 

 

Concepts of the President’s Commission on Heart Disease, Cancer, and Stroke
Micuae. E. De Baxey, M.D. *

 

 

IT IS A MATTER OF GREAT SATISFACTION to those
of us who served on the President’s Commission
on Heart Disease, Cancer, and Stroke that sub-
mission of our Report in December has been fol-
lowed by the introduction, early in the present
session of Congress, of legislation embodying
several of our key recommendations.

A primary objective of the Commission,
throughout our deliberations, was to bring to-
gether the worlds of medical research and medical
practice to serve the needs of patients suffering
from the three great killer diseases. To achieve
this end we designed a system of regional net-
works or complexes, made up of research centers
and diagnostic and treatment stations, based upon
and related to an existing medical center.

These complexes were envisioned, not as an
entirely new system of medical services super-
imposed upon a region, but rather as a means of
strengthening and pulling together the medical
resources now in existence. In such a system, each
physician would have, readily accessible to him
for the benefit of his patients, the full range of
up-to-date knowledge and skills already developed
through research. At the same time, each physi-
cian would be contributing to the generation of
new clinical knowledge.

The proposed Heart Disease, Cancer, and
Stroke Amendments to the Public Health Service
Act, would authorize grants to medical schools,
universities, research institutions, and other pub-

 

Baylor University College of Medicine, Houston,
Texas; Chairman, President’s Commission on Heart
Disease, Cancer and Stroke.

lic or private nonprofit agencies for the purpose
of planning and developing such regional coordi-
nated arrangements. Applications for such grants
would be reviewed by a new Advisory Council
to the Surgeon General on Medical Complexes.
Among other requirements, each grantee would
need to demonstrate that all important medical
elements of his region were involved in the plan
through the formal establishment of a local ad-
visory body.

Each complex would have three interlocking
purposes: the advancement of knowledge through
research, the strengthening of manpower resources
through teaching programs, and the demonstration
of patient care in the fields of heart disease, can-
cer, stroke, and such other major diseases as may
be deemed appropriate. Funds granted could be
used for nearly any purpose associated with the
development of the complex—including construc-
tion of needed new facilities, support for teaching
programs, and _staffing—although payment for
the costs of patient care may be made only as they
relate to research, teaching or demonstration.

Thus this is not essentially a construction pro-
gram, although new facilities will be constructed;
it is not wholly a research program, although re-
search will be advanced. Nor does it represent a
revolutionary intrusion into the realms of health
economics as related to patient care.

At root it is a program of fusion among re-
search, teaching and medical service, to a degree
not previously achieved. In this lies its innovation.
We believe that the enactment of the Heart Dis-
ease, Cancer, and Stroke Amendments will
strengthen our national medical resource in deal-
ing with these diseases, and we commend it to
your professional attention.