IN the decade ahead, medical education in the United States will be governed more than ever before by inflexible economic imperatives. In the past century economic imperatives were overshadowed by reforms that centralized the education of physicians in universities and their teaching hospitals, by the advent of sophisticated and successful surgical intervention, by the development of a scientifically based and powerful materia medica, and finally, by an extraordinary dependence on technology in diagnostic medicine. At each stage, society was willing to commit the needed resources, and each stage yielded dramatic returns. Public faith in medicine as a force in preserving.
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