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Summary
Teaching hospitals, a critical component of medical education and a provider of indigent
care, are in crisis. Competition from our own well-trained graduates practicing in
sophisticated community hospitals, the rapid development of managed care, federal
restructuring of funding, and erosion of our public economic base are important factors.
The failure of teaching hospitals is likely to adversely alter medical education and
threaten our professional status as doctors and educators as we compete to survive.
The problem is identified, but the clear solution is not. My treatise began with the
idea that the public recognizes that their teaching hospitals are in crisis. Yet there
is some element of public optimism reflected in a Time magazine article that states, “Whatever happens, no one doubts that teaching hospitals
will survive.” 1 Although neither government nor medicine are widely respected as organized entities,
we do have the best medical care system in the world and the most trusted politicians
and doctors on an individual basis. We may or may not be able to improve things substantially,
but we must try. In spite of difficulties in the process, we will ultimately live
up to Sir Winston Churchill's expectations: “The American people will… do the right
thing, but only after they have tried everything else.” 2
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Article info
Footnotes
*President's Address, presented at the 48th Annual Meeting of the Southwestern Surgical Congress, Scottsdale, Arizona, April 28–May 1, 1996.
Identification
Copyright
© 1996 Excerpta Medica, Inc. All rights reserved. Published by Elsevier Inc.
