The discrepancy between current medical practice and the capabilities
for improvement is greater now than at any time since the early part of the
last century. In the early 1900s, the emerging sciences of chemistry, biochemistry,
anatomy, physiology, pathology, physics, and microbiology provided the potential
to transform medical practice. Nonetheless, the field was anecdotal, unscientific,
and unregulated. In 1910, the Flexner Report influenced the development of
the modern academic medical center, where students are educated and trained
by research-oriented faculty who practice in teaching hospitals.1 This
integration of the core missions of education, research, and clinical care
led to understanding the pathophysiologic basis of diseases and therapeutic
modes capable of modifying them.
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