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November 1992

Living With Hippocrates in a Changing Medical World, With Particular Reference to the Patient-Physician Relationship: Just as you ought not attempt to cure eyes without head or head without body, so you should not treat body without soul. Socrates

Arch Intern Med. 1992;152(11):2184-2188. doi:10.1001/archinte.1992.00400230010002

Medicine has undergone profound changes since 1929, when I entered medical school. Increased private and public support of research, especially after World War II, created a favorable milieu for the expansion of medical manpower, hospitals, and academic medical centers. Biomedical research flourished as never before, with unprecedented advances in medicine, including the development of antibiotics, kidney dialysis, computer science and computerized scanners, ultrasonography, magnetic resonance imaging, fiberoptic endoscopy, organ transplants, coronary bypass grafts, dissolution of gallstones, and genetic engineering: medical options unimaginable in the 1930s.1

The nature of medical practice has changed from general practice to predominantly specialization,2 with emphasis on professional accountability and recertification. The independent physician has been succeeded by group practice. Medical centers, health maintenance organizations, and emergency departments have replaced local doctor's offices. Clinical and research organizations have so multiplied as to provide educational opportunities in all fields at all times and in all

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