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Abstract
Many barriers exist to the delivery of preventive services by both cardiologists and
other physicians. These barriers can be overcome by appropriate training and the development
of supportive infrastructures. In addition, institutional priorities must change in
a direction that encourages such efforts. Cardiologists must recognize the importance
of risk-factor modification, and training programs in cardiology should teach appropriate
counseling techniques, the use of risk factor-lowering pharmacologic agents, and the
manner in which cardiologists should interface with dietitians and other ancillary
personnel. In addition, we need to recognize and teach, both by didactics and by example,
that counseling patients and carrying out long-term preventive interventions can be
as gratifying and interesting as performing dramatic procedures that although valuable
and rewarding take place at a very late point in the patient's clinical course and
perhaps could have been averted by greater attention to risk-factor modification.
Increasingly, the public and governmental agencies are becoming involved in encouraging
these endeavors, and cardiologists should be in the vanguard of such efforts, not
reluctantly bringing up the rear.