PHYSICIANS AS LEADERS IN IMPROVING HEALTH-CARE - A NEW SERIES IN ANNALS OF INTERNAL-MEDICINE

Searching for one word to describe the state of mind of the physician in the United States today, we might choose beleaguered. Threats appea r from all sides-from payers, would-be managers of care, the growth of technology, and even patients. The rhetoric is one of siege and battl e, and the dynamic seems to be a clash of values from which only one w inner can emerge. But scientific and health services research suggest otherwise. Science suggests that health care could, indeed, perform a great deal better than it does today and that a shared aim of improvin g health outcomes for patients at a cost that society can afford is se nsible and within reach. However, achievement of these improvements wi ll require of physicians not handwringing and resistance to change but concerted, positive, capable leadership. The goal of this series in A nnals is to describe a new knowledge base that will help physicians pa rticipate effectively in the redesign of the health care system. The s eries is intended to raise the curiosity of physicians about the skill s they will need to become more active and influential citizens of the health care community in accomplishing improvements. These skills wil l help physicians better deploy their clinical expertise and professio nal purpose in a debate that has heretofore been informed primarily by economics.