"The prompt and accurate diagnosis of many diseases has been facilitated in recent years by technological advances in medical imaging and clinical chemistry. At the same time, the clinician''s ability to treat disease had also been enhanced by the development of many useful new medications; the conduct, publication and widespread communication of major clinical trials; the development of useful clinical guidelines and critical paths; and the ready access to other sources of information; MEDLINE, Web sites, professional societies, and many others.

Despite these advances in diagnostic capabilities and availability of information, prescribing drugs optimally has not become correspondingly easier. Modern healthcare management has often increased expectations that primary-care physicians will assume more direct responsibility for the comprehensive medical management of patients with a wider range of diseases. Access to prompt consultation with subspecialists is sometimes restricted.

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