Survey of physicians from around the country attempting to explain why there is a decrease in PCI (angioplasty) volumes. The different explanations and regional variation is fascinating. My views are similar to the New England practioner surveyed. In Massachusets we have the lowest level of uninsured patients in the nation so the economuc factors here are less likely a contributor. Has a hopeful optimist and enthusiast for prevention strategies I favor stain use as the #1 cause. I think the COURAGE trial had no impact at all.