a National Academy of Medicine. These gave way in November 1967 to the activities of the Board on Medicine, a group convened in Washington by the National Academy of Sciences. What emerged in 1970 was the Institute of Medicine. An institute not an academy, the new organization nonetheless reflected the ideas of all three men.

The Page Discussion Group

Between 1964 and 1967, Irvine Page had the field pretty much to himself, although he was not alone in proposing a National Academy of Medicine. In the fall of 1960, a six-person task force, which contained no fewer than four future members of the Institute of Medicine, advised President-elect Kennedy of the need to establish a National Academy of Medicine ''comparable to the National Academy of Sciences.'' President Kennedy showed little interest in this recommendation, preferring to concentrate instead on the creation of Medicare, as the expansion of Social Security to pay the hospital bills of Social Security recipients became known. When Irvine Page wrote his editorial on the need for a National Academy of Medicine in 1964, Medicare was a hotly contested issue. On September 2, 1964, within weeks of the appearance of Page's editorial, the Senate approved a version of the measure.

It was no wonder, then, that Page led his editorial by calling attention to the "important trend linking medicine to government." A group from the medical profession was needed to provide the government with the impartial yet expert advice necessary to make "decisions of wisdom" on questions of medical policy. The American Medical Association, according to Page, approached the federal government with a "grumbling hostility" that limited its effectiveness. The Association of American Medical Colleges, a similarly venerable organization that was in the process of transforming itself from a "congenial 'deans' club' into a powerful lobby for academic medicine," represented the interests of academic health centers, not the medical profession. Few other organizations were large or influential enough to speak for the profession. Page believed that the solution was a National Academy of Medicine, located in Washington, D.C., that would be "truly representative of excellence in all branches of medicine."1

Irvine Page was the logical leader of a campaign to create a National Academy of Medicine. Like nearly everyone who helped found the Institute of Medicine, he came from the fields of academic medicine and scientific research. He combined a high academic

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