In the committee's view, the starting point for dental schools is an affirmation or reaffirmation that patient care is a distinct mission that is related but not subservient to the educational and research missions. Dental educators and students must be as conscious as the private practitioner of patient needs, preferences, motivations, and limitations.

In preceding sections of this chapter, some specific options for dental schools to improve their patient care mission are proposed or implied. They include

• strategic planning that anticipates continued restructuring of the health care system;
• adoption of a formal, comprehensive quality assurance and improvement program;
• increased faculty accountability for patient care and more reliance on residents (for schools that have relevant graduate programs);
• more efficient administration of nonclinical activities;
• improvement of information systems to support outcomes research, quality improvement, and effective management;
• possible separation of accreditation programs for education and patient care; and
• integration with the patient care activities of the entire academic health center.

Strategic planning considers alternative futures and approaches for dealing with both more and less likely contingencies. For most dental schools, the planning process occurs within the broader framework and constraints of strategic planning for the university or academic health center. Chapter 7 recommends that dental schools, as part of their strategic planning process, undertake a very explicit assessment of their position—assets, deficits, opportunities, constraints—within this larger environment and identify objectives and steps to strengthen their position. Patient care will figure significantly in any such effort.

Almost any future for a dental school will involve most of the elements discussed below, including more patient-oriented care, formal quality assurance processes, and improved information systems. Some schools will see integration in a larger system as a feasible