James P. Nolan, MD; Thomas S. Inui, MD
Internal medicine has been in a dynamic process of change throughout this century (1). Much of the ferment has resulted from new knowledge about disease causes and treatments, development of new technologies, shifts in the settings of care (for example, from office and home to hospital early in this century), and the leadership of notable individuals in internal medicine who established new norms for the discipline and its institutions. A present-day observer could contend that all of these preconditions for change are present again. Additional forces driving the process are the oversupply of specialists and the spiraling costs of health
Nolan JP, Inui TS. Tinkering or Real Reform? The Choice Is Ours. Ann Intern Med. ;116:1042–1045. doi: 10.7326/0003-4819-116-12-1042
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Published: Ann Intern Med. 1992;116(12_Part_2):1042-1045.
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