THE SOCIAL-RESPONSIBILITY OF PHYSICIANS AS AGENTS OF PUBLIC-HEALTH SERVICES

The physician who is entrusted with a large quantity of resources for the treatment of ARF/MOSF has a social responsibility for optimizing t he treatment, auditing the outcome, and where possible, preventing the illness. Best treatment includes not only modem techniques bur also e fficient organization and leadership of the ICU team. Audit is an indi vidual responsibility, may be fruitfully pursued on a multicenter basi s, and is a cost-containment discipline. Audit of the St. Thomas' Hosp ital ARF program has resulted in a predictive scoring formula. This is used to illustrate a cost-effective analysis related to disease sever ity Prevention of ARF/MOSF is a challenge to emergency services. There may also be a considerable opportunity to prevent ARF in highrisk sur gical patients. A randomized study carried our at St. George's Hospita l illustrates the health gains which could result.