A managed care world - Can academic activities survive?

As a guest speaker at the Brown University Medical School Graduation, the author described some aspects of managed care that impact on academics and more specifically teaching and research. The issues for education included the reduction in numbers of residents and fellows; the rapidity with which the patients must be treated; the reduction in monies for educational activities; and consuming and at times needless paperwork. As far as research is concerned the reduction in time and money have had a negative effect on this important aspect of academic life for physicians. Several proposals are put forth to maintain the quality of these educational and investigational pursuits, and the students soon to be residents and, hopefully academicians are advised to maintain the highest standards and appreciation for quality care, education, and research.