Toward the new pattern of medical practice

As this article is being written, in the fall of 1993, we are waiting for the details of the President's plan for extending health insurance coverage of some kind to all members of the population while also containing costs. All observers, including practicing members of the medical profession itself, believe that a sharp break with the past is developing, most particularly a break with the old pattern of practice that flourished during the golden years between the end of World War II and the end of the 1960s, when the federal government made its first effort to control costs. In this article, I will discusses changes in the conditions of American medical practice that most observers can agree on. Then, I will summarize the major conceptions of the future shape of medical practice. I will conclude with my own view of critical issues in the constitution of practice, issues whose resolution depends not only on broad public policy initiatives, but also on the activities of physician executives within the medical community.