Academic medicine's season of accountability and social responsibility

The author declares that academic medicine has entered a new and stormy "season" of accountability and social responsibility, due to public concerns about the overall health care system. He reviews earlier seasons, identifying paramount issues or activities that dominated the specific eras the Association of American Medical Colleges (AAMC) has responded to since the twentieth century began. He recommends how the AAMC can achieve several near-term solutions to pressing demands of the current season, such as the needs to manage academic medical centers more efficiently and to restore public confidence in the integrity of biomedical research. Next, he focuses on proposals for academic medicine to provide leadership, through the AAMC, in two major areas: preparing more generalist physicians, and assuring greater access to health care for those who live in underserved urban and rural areas. He describes models of existing, successful programs. The author concludes by proposing to create a "National System of Regional Medical Care." He urges the AAMC to continue its leadership by designating a task force to examine how such a regional system could be established within this decade.