The article analyzes three challenges confronting academic medical centers in the areas of education, patient care, and research. Encouraged are: (1) an expanded role by medical centers in training primary care physicians; (2) modification of physician reimbursement policies; and (3) resolution of conflicts of interest for biomedical scientists in…

An interview with the former editor of "The New England Journal of Medicine" examines the impact on medical education of corporatization of the health-care system, including pressures to see more patients, less time spent with each patient, financial pressures limiting medical research, issues related to tenure, and concerns that young doctors are…

An interpretation of the dollar dimension of medical progress, the role of nonmonetary factors in the equation, and suggestions for public policy are presented. Medical leadership must help formulate recommendations aimed at reductions in medical school enrollments, fee schedules for physicians, costly technology, etc. (MLW)

This keynote address reviews previous efforts at developing a research policy agenda for child abuse and neglect, reviews medical research directions in child sexual abuse, suggests the author's views of potential research areas, and suggests a policy infrastructure to further implementation of the conference's proposals. (DB)

This discussion of traditional academic medicine's resistance to changes in practice, technology, and finances looks at three current problems in medical education and two in biomedical research. Solutions are proposed, based on redefinition of the relationship between universities and medical schools and expansion of the conventional narrow focus…

Three principal aspects of capital needs in biomedical research are discussed: the significant and growing need for capital; sources; and the role of federal policy. Important assumptions, questions, and possible future trends are discussed. Consolidated thinking and effort are encouraged. (MSE)

Discussion of academic medical centers (AMCs) looks at: change due to heavy federal funding in recent decades; adverse consequences, including deemphasis on education in favor of research and clinical service delivery, and discrepancies between AMC internal and external labor markets; and challenges to medical education in research, education, and…