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March 20, 1981

Future Medical Practice in the United StatesA Choice of Scenarios

JAMA. 1981;245(11):1140-1143. doi:10.1001/jama.1981.03310360032018

IN 1966, Creech1 published a provocative article entitled "Medical Practice in 1990," wherein he projected the likely features of the medical care system based on apparent trends in medical education and practice since 1890 in this country. He painted a bleak scenario for 1990, illustrated by the following excerpts:

The private practice of medicine will no longer exist as we know it. Physicians will be geographic full-time employees of the medical center complex, within which they will provide total medical care for the residents of the community, preferably on an annual fee basis, but perhaps as salaried employees of the federal government.... Medicine will be practiced on an assembly line basis.... [Physicians] will no longer concern themselves with the routine practice of medicine, which will be done by others whose training is more vocationally oriented.

In just 14 years since 1966, major changes have taken place in medical education