Since World War II, multiple changes have occurred in medicine that are now
affecting academic health centers and department of surgery chairpersons.
None of these changes by themselves were intended to adversely affect depar
tment of surgery chairpersons, but the sum total effect constitutes a negat
ive external force. In addition, there are internal forces in the schools o
f medicine and university hospitals that may negatively affect department o
f surgery chairperson in fulfilling the stated goals of excellent patient c
are, teaching, and research. Many of the problems brought about by these ne
gative forces cannot be solved by a single department chairperson. However,
individual department chairs can contribute to the solution by returning t
o the values taught to them by the role models of their surgical training.