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January 8, 1997

Tomorrow's Hospital: A Look to the Twenty-first Century

Author Affiliations

University of Pennsylvania Philadelphia

JAMA. 1997;277(2):173. doi:10.1001/jama.1997.03540260087043


It took 100 years from the development of the first modern hospital in the United States (arguably the Johns Hopkins Hospital) for hospitals to become the paramount medical care institutions. We will look back longingly to the 1980s as the time when hospitals were the temples of treatment. They were the workshops of the most knowledgeable specialists, educated students and trainees, produced vast quantities of research, used all the latest technologies, and had the bulk of power, prestige, and resources. People were born and died there, and every medical event was provided for in between. This was all paid for willingly by private and public sectors, and patient and physician preferences reinforced beliefs and behavior. It took but the last 10 years to turn the halcyon days into a financial and organizational shambles for hospitals. The inability or unwillingness of hospitals and physicians generally to deal with economic realities