title: The thoracic surgical industrial complex.
abstract: The thoracic surgical industrial complex is an industry worth $2 billion per year and is shaped by six dominant forces, three positive and three negative. The three positive forces are technological innovation, entrepreneurial activity, and the flow of capital and the three opposing forces, government regulation, cost-containment, and the excessive costs of product liability insurance. We are now at a critical time in the evolution of this industry, with growth being enhanced in areas of lesser risk, namely, nonimplantable devices, at the expense of high-risk implantable devices. The future of the artificial heart hinges on the balance between the six forces, and this analysis examines the possibilities for timely development of this ultimate implantable device.
mesh_terms: D003257:Consumer Product Safety / Q000191:economics; D003363:Cost Control; D005544:Forecasting; D006355:Heart-Lung Machine / Q000266:history; D049673:History, 20th Century; D006801:Humans; D007351:Insurance, Liability / Q000191:economics; D008389:Marketing of Health Services / Q000191:economics / Q000266:history; D019736:Prostheses and Implants / Q000266:history; D013675:Technology, High-Cost / Q000191:economics / Q000266:history; D013903:Thoracic Surgery / Q000191:economics / Q000266:history / Q000295:instrumentation; D014481:United States