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Tuberculosis Care: When and Where?

LEE B. REICHMAN, M.D., M.P.H.
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Presented in part 21 May 1973 at the Public Health Sessions, Annual Meeting of the American Lung Association, New York, New York.

▸Requests for reprints should be addressed to Lee B. Reichman, M.D., Executive Medical Director, Bureau of Health Care Services, 330 W. 34th St., New York, NY 10001.


New York, New York


Ann Intern Med. 1974;80(3):402-406. doi:10.7326/0003-4819-80-3-402
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Modem medical management of tuberculosis is widely accepted and practiced; however, beyond medical methods and principles, the attitudes of the medical professionals and lay persons alike reflect long-standing, unwarranted fear rather than true scientific thinking. This is mainly because tuberculosis has always been and often still is handled outside the mainstream of medical care. Much specific research and even more circumstantial evidence dictate that tuberculosis is spread mainly before diagnosis, so that hospitalization usually is unnecessary to protect contacts; is spread mainly by droplet aerosol from an untreated patient, so that gowns and most isolation procedures provide a false, unnecessary security; can be treated efficiently in an outpatient setting, so routine hospitalization is unnecessary for treatment; and becomes noninfectious rapidly, so most patients can return to work quickly. Unfortunately, most of these advances are not accepted by practicing physicians and public health officials. Except for the advent of drugs, tuberculosis is now treated emotionally, as it was in the last century.

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