Should we expand imperfect treatments, or create new ones?

We will need to ask ourselves whether medicine—both clinical practice and scientific research—should focus on the development of novel treatments or instead on ensuring that existing treatments are effectively used. Health should be thought of as a function of two attributes: potential health—a matter of identifying the best medical outcome available—and attained health, or how close we come to achieving this goal. When advocates of attained health survey the landscape, they see an appalling misallocation of resources. They see a lot of money being used—in both research and practice—to produce what are often only slight advances at best in potential health.