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January 1971

The Academic Department of Medicine and Social Change

Author Affiliations

Durham, NC

From the Department of Medicine, Duke University Medical Center, Durham, NC.

Arch Intern Med. 1971;127(1):80-84. doi:10.1001/archinte.1971.00310130084011

Thest 25 years have witnessed a phenomenal increase in biomedical knowledge that has transformed medical practice and education. Spectacular advances in the prevention, diagnosis, and treatment of disease have been accomplished by the systematic application of the developments of the physical, biological, behavioral, and social sciences to problems of medicine and medical care.

Scientific medicine is complex medicine, despite the clarification it has allowed. It is difficult for the single physician in solo practice to remain abreast of all of the advances in concepts and technology. One result has been the decline of the general practitioner and the rise of specialism. Another has been the increasing pattern of group practice under a variety of organizational treaties. The concurrent decay of our cities and the flight of physicians from the urban areas have left huge segments of the inner city without personalized medical care. The new national goal of access

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