In the next 25 years, the IOM must become the conscience of the nation in the quality arena. It must deal with the big issues and demand that the information needed to address them be produced. It must do work that will yield specific recommendations that are geared to maintaining quality while all the pressures on the health system are geared to reducing it. Most of all, the IOM must succeed—the consequences of failure will be too high.

REFERENCES

Brook, R.H., Fink, A., and Kosecoff, J. 1987. Educating physicians and treating patients in the ambulatory setting: Where are we going and how will we know when we arrive?Annals of Internal Medicine 107:392–8.

Institute of Medicine. 1978. A Manpower Policy for Primary Health Care. Washington, D.C.: National Academy of Sciences.

Institute of Medicine. 1994. Defining Primary Care: An Interim Report,Molla S. Donaldson, Karl Yordy, and Neil A. Vanselow, eds. Washington, D.C.: National Academy Press.

Kosecoff, J., Fink, A., and Brook, R.H. 1985. General medical care and the education of internists in university hospitals: An evaluation of the teaching hospital general medicine group practice program. Annals of Internal Medicine 102:250–7.



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