This is a discussion of the process by which new research ideas are developed, receive clinical trials, and become new therapeutic or diagnostic tools. (BB)

The influence of new medical instruments is large but not always easy to interpret. However, this author attempts to do just that. Included topics are: general trends, computers, economic considerations, and regulatory constraints. (BB)

Early clinical trials (observational or randomized) hasten the prompt evaluation of new operations. Early clinical surveillance facilitates the design and implementation of randomized clinical trials when they are necessary. Long-term surveillance of operations allows continuing evaluation when their use becomes widespread. (BB)

Discussed is a projected overabundance of physicians by 1990 and a possible cut in funding in medical schools because of this overabundance. Also discussed is the shortage of clinical investigators who are physicians because salaries for physicians are much higher than for clinical investigators. (DS)

Discusses the rising trend supporting for-profit hospitals. Compares for-profit and not-for-profit hospitals in regards to hospital costs, quality of care, care for the poor, education and research, and the role of the physician. (TW)