The future of American medicine1

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The author discusses the far-reaching changes that have been taking place in the medical field, the effects that these changes have had on the current practice of medicine, and some of the future changes that can be anticipated. Advances in basic science and in technology have brought about rapid changes in diagnosis and treatment, and changes in social consciousness have both made medical care more available to a larger proportion of the population and also changed the delivery of that care. Changes in the financing of medical education affect the people who enter the profession and their choice of specialties. The emergence of prepaid practice plans, the application of business methods to health care, and open competition in the health care marketplace have already changed health care delivery, and will no doubt continue to do so. Likewise, computer technology continues to change medical practice drastically, and the problem of physician liability is far from being solved. The survival of medicine as a discipline will depend oil the ability of its practitioners to adapt to the changing environment, to plan for rational change, and to accept a new social responsibility in addition to their traditional commitment to scientific excellence.



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