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To The Editor.
—In a recent editorial in the Archives (1983;143:212-213), Landau theorizes that professors of medicine have in some way abandoned their leadership role in medical society. I think this does not represent dereliction, but rather the inevitable consequence of changing referral patterns, and of rapidly advancing technology.Many patients now obtain medical care in their home communities, largely from university-trained physicians, and fewer patients are referred to university hospitals.The new technology has taken away much of the aura of bedside diagnosis. It would be difficult, even for Sir William Osler, to make rounds in this day of computed tomographic scans and other sophisticated diagnostic tests. This has resulted in the virtual extinction of the great clinicians; not a happy occurrence, in my opinion.Dr Landau asks if the "real" doctors, the community physicians, are expected to become the role models for students and young physicians. The obvious