The author discusses the need to create structural reforms in the nation's health care system, built around a consensus on workable, affordable solutions, the first of four needs in this area, and presents a set of principles that must frame the debate on health care reform (e.g., that health care must be accessible to all Americans). He also presents practical options that address the United States' most urgent health care concerns (e.g., making the cost of health insurance more affordable for small businesses). The second need is to preserve and strengthen the nation's biomedical research enterprise; the author outlines steps that are already under way to deal with this need (e.g., the development of a Biomedical Research Initiative in the Public Health Service and the allocation of funds for various research-connected activities). The third need is to increase the participation of minority youth in science and the health professions; the author outlines steps that are being taken to encourage such participation (e.g., helping historically black colleges and universities and funding training programs for training minority professionals in health care). The last need discussed is to foster a culture of character: empowering citizens to take control of their own lives to eliminate costly debilitating illness before it strikes. For all these needs to be addressed successfully, it is crucial that the involvement of the academic health professions community and the community at large be expanded.

Delivery of Health Care↗

PubMed1992

Skills necessary for contemporary health professionals.

There is a constant need for all doctors to be 'renaissance health professionals', to have a mastery of a broad set of medical, communication and information-processing skills. Education in these areas must continue after graduation to produce the most effective medical care. With the changing face of medicine in the next few years, these skills will be more vital than ever before. Hence doctors and institutions of medical education must encourage the development of a wide range of skills as part of the learning and practice of medicine.

Clinical Competence↗

PubMed1992

Health promotion and disease prevention.

Health promotion and disease prevention programmes improve the health status of populations, preserve freedom, and empower individuals. Yet, despite important advances in many countries, including a more health-conscious public, it would be beneficial in the United States and in other countries to have a comprehensive plan to make health promotion and disease prevention personal and societal priorities. I have called this climate a 'culture of character', a climate of individual responsibility to encourage healthy behaviour. I want to encourage the readers of Medical Education to participate in the formulation of plans to implement greater health promotion and disease prevention efforts. Such a climate of personal responsibility could be created if doctors, educators and policy-makers agreed on some workable, positive goals and steps that would help meet realistic national goals over a defined period of time. If there were such agreement, then doctors could more clearly focus their own efforts with their patients, in concert with other health professionals, and with policy-makers who have the same goal--healthier people.

Health Planning↗

PubMed1992