The Top 10 Medical Advances of the Decade

"The ways in which computer systems are improving hospital care ... is pervasive and radical," said Dr. Margaret Humphreys, editor of the Journal of the History of Medicine.

But many physicians have been reluctant to go digital because there is a significant upfront investment, which is why several of the health care reform measures now before Congress include provisions to underwrite some of this cost.

With or without reform, the Obama administration has an ambitious program aimed at converting paper records to electronic health records. It has earmarked $20 billion to pay for the switch-over and named medical wonk Dr. David Blumenthal to serve as national coordinator for health information technology.

3. Anti-Smoking Laws and Campaigns Reduce Public Smoking

There is no national smoking ban in the United States. However, 27 states and the District of Columbia have enacted restrictions, including seven states that banned smoking in bars and casinos in recent years.

In a report issued last October, the Institute of Medicine said those public smoking bans have cut exposure to secondhand smoke, which, in turn, has contributed to a reduction in heart attacks and death from heart disease.

Dr. Lynn Goldman of Johns Hopkins Bloomberg School of Public Health, who chaired the committee that wrote the Institute's report, said the debate was over and that, "Smoking bans work."



Experts on the history of medicine agreed.

In the United States, "anti-smoking campaigns, including banning of smoking in workplaces and public places [has] enormous impact across socio-economic classes on many diseases," said Humphreys of the Journal of the History of Medicine, who added that smoking increases the risk for strokes and many cancers.

"In terms of the greatest good for the greatest number, there can be no doubt that the decline in smoking has had the greatest impact," Humphreys added. "Virginia and North Carolina are just getting around to banning cigarettes in all restaurants now, so the public bans do track over the last 10 years."

While public smoking bans protect people from secondhand smoke, doctors said they also motivate people to quit.

"It's probably the most important 'doable' public health measure for decreasing morbidity and mortality," said Dr. Richard Kahn of Tenants Harbor, Maine. "There is good data that as it becomes more difficult for people to smoke, more will quit."

4. Heart Disease Deaths Drop by 40 Percent

Those looking for dramatic improvements in public health need look no further than the world of heart disease.

A mere 25 years ago, when a patient came to a hospital with a heart attack, the best that could be done was to put the patient in a darkened room, give him or her morphine for pain and lidocaine, which doctors believed would prevent dangerous irregular heartbeats, and hope for the best.

Heart attacks, called infarcts, were "big" and the damage to the heart muscle often was catastrophic, leading eventually to heart failure and death.

By contrast, treating a heart attack now is all about speed: Speed the patient to the hospital so that a clot that blocks the life-saving flow of blood can be "busted" with drugs like the genetically engineered tissue plasminogen activator or tPA.



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