How is it that we have such great hospitals—and such poor public health," the Philadelphia Inquirer (August 22, 1989:14-A) asked the academic medical community of Philadelphia. Instead of just "cranking out specialists," the editorial said,"academic medicine ought to be taking stock of its broader vision—preventing sickness, making care more easily available, and figuring ways to improve the state of public health.... On matters of public health, academic medicine has been embarrassingly slow to show leadership."
On the one hand, it is certainly not fair to blame the university medical centers for the fact that too many of this country's people do not receive basic medical care. In fact, these centers spend a great deal of time and expertise dealing with the consequences of this society's failures in public health.
On the other hand, who is better prepared to attack these problems than the academic medical community? It seems hard to