Healthcare on the horizon: getting ready for a preferred future

The untenable cost of health service entitlements and the indefensible per-unit cost of service have provided the impetus for radical changes in healthcare service provision, including managed care. In a managed care environment, focusing solely on sickness care threatens the viability of the organization. Careful assessment of service structures should occur, a shift in the strategic efforts of the system is defined and a refocusing of the design of service is a central component of the organizations work. A more integrated organizational model and a broader understanding of health care service are the keys to survival. Changes we have seen so far lay the groundwork for a large-scale evolution that will take place over the next two decades. Developments that remain ahead include increased emphasis on health maintenance and growing effort to bring health services into the community itself. Wise health professionals will be thinking in terms of a career rather than a job. Education, breadth of talents, portability of skills and mobility of role become central to the ability to thrive in the new decade. Today's unpredictable atmosphere demands insight, fluidity and willingness to change and grow.