Cardiovascular care in the urban melting pot.

The widespread prevalence of cardiovascular diseases does not spare poor or heterogeneous urban communities. Since the inflationary spiral of health care costs has continued unabated, it will require intentional and creative maneuvers to preserve and develop new or existing programs which do not deny ready access to quality care for all classes. It is the opinion of the author that the present health care system promotes indifference on the part of health care providers and the purveyors of technology. The traditions of altrusim in medicine should be extended to health systems planning at the institutional and regional level. Although preventive medicine is a vital public issue, it is not the only priority agenda for populations experiencing already existing cardiovascular derangements. The private practice paradigm is an obsolete and inflation promoting system for the delivery of complex tertiary care. Modern cardiovascular diagnostics and therapeutics require efficient and economical team efforts. If the few remaining historically black medical centers are to properly serve a heterogeneous base, innovation and reorganization are inevitable.