Adverse outcomes of underuse of beta-blockers in elderly patients

Abstract

To the Editor. —I read with interest the Editorial by Drs Felch and Scanlon.1 They speak of the dream for medicine for the new millennium, "that the care of patients will be evidence based," and that this can only be "fully realized when the major players in the health care field find improved ways to work together." They close by saying, "We envision the likelihood that new mechanisms will be found to alert clinicians about the existence of innovation. We hold firm to the right of frontline physicians to make the choice of using it (to follow a recommendation) or to cite their reasons for not using it." In Iowa, we are proud to point to the existence of a program that for the past 24 years has done this very thing—the Iowa Statewide Perinatal Care Program. This program consists of a perinatal review team that includes a maternal-fetal medicine specialist, a neonatologist,