Known Pieces of the Medical Science Puzzles - Part 2

As we can see, there are known pieces of the medical science puzzle. This means that the question is no longer, if there are known pieces of the puzzle, but what are they and how do they fit together. This, in turn, leads to the question, are there any gaps in the picture. However, the complexities are already beginning to show. The one piece of the American Heart Association is turning into a puzzle, itself. This kind of gives the indication that the medical science puzzle may have no easy edges to use as a guide, but instead is a composition of other puzzles. If this is the case, an understanding of the larger medical science puzzle can be derived (extrapolated) from the American Heart Association puzzle.

From the pieces collected, in part 1 of this article, we can see that the American Heart Association is large enough to cover the medical science area of cardiology. We also see, that the general overview (picture) of the AHA (American Heart Association) is one of a scientific society that evolves into a social agency. A serious issue raised in the article, Science is No Place for Fudge [Dr. Daniel Carras, PhD, DMSc, MD[Defending] - Week 1 Vol 0 of this journal] . This article introduces the scientific issues occurring in the medical science community, and we see the AHA evolve right into these problems. The question here is what has been the effect?

The answer requires further investigation and the best place to start, in the AHA puzzle, is the final 2004 Annual Report. The first question was, how far has the AHA evolved? We find that (on page 2) that the AHA had a total income of $652,921,542 and spent only $132,655,795. Here's where the fudging begins, they have their research expenses listed as 23.7%, but when calculated against the total income, the research expenses only can up to about 20%. So where did the "23.7% come from? It's the research expenses calculated against total expense, not the total income - it's a "forward-looking" adjusted result. It places the best possible look on the evolution of the AHA. Promotion can be seen as any activity to present the image of the AHA. Here the total expenditure was, ($200,912,662 - public education, $81,033,906 - fund raising) $281,946,568 or 41% at a minimum, and $387,635,033 or 59% - if you consider the promotional value of ($66,540,327 - professional edu & training and $39,148,138 - community services).

So what's happened to the science that the AHA relies on?

"(1)In organizations, one good decision can produce far-reaching benefits. Our renewed focus on “putting passion into action” is a perfect illustration. Emphasizing the personal impact of cardiovascular diseases has created new excitement and energy for our cause, which has led to new opportunities and a host of new achievements. » Our passion for reaching others was evident when Go Red For Women debuted and put a red spotlight on the long-neglected issue of women and heart disease. Our Women’s Primary and Secondary Prevention Guidelines received widespread coverage as a result. Go Red For Women continues as a year-round campaign that will be renewed each February. ... (2) To increase our impact in emergency care, we’re evolving our very successful local Operation Heartbeat and Operation Stroke initiatives into new efforts that focus on improving Emergency Medical Services infrastructure statewide. (3) Our commitment to improving heart and stroke education, care and services remains unwavering; now we’re focusing more efforts on advocacy, strategic alliances and Get With The Guidelines–Coronary Artery Disease and Get With The Guidelines–Stroke, two proven quality improvement initiatives. These programs help hospitals establish protocols and follow guidelines in treating and discharging patients to reduce future cardiovascular events. » (4) We’re also passionate about serving customers, including the researchers and scientists who are so vital to our association. To better meet their needs, we launched an enhanced membership program. Now members have an array of new services, including greater access to scientific information and better networking opportunities. » (5) It’s been said that what you give comes back to you. That’s certainly been true this year. The more we’ve shown our passion for serving our constituencies, the more they’ve responded by supporting our cause. This year our fund-raising revenues rose a remarkable18 percent over last year. " [Page 6, letter from Chairman of the Board and President]

(1) is a statement of hope, which in itself is not bad, but the actual results are - lacking. In fact, much of the statements throughout the 2004 annual report, are of the "forward looking type. The only stats provided is the year over year financial increase. The only statement, (4) from the above, that mentions the "science" that their success depends on - view the scientists and research as customers, not as an integral part of the AHA - which is no longer a scientific organization, but a social agency. Much of the report reads just like the warnings of scientific integrity stated in the journal, Science.