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Edmund D. Pelligrino, MD
JAMA. 1968;205(8):585. doi:10.1001/jama.1968.03140340055016.
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Perhaps the largest social issue before the health professions today is the optimal utilization of the capabilities of each member of the health care team for the benefit of the patient. We are clearly far from knowing how best to mobilize our personnel resources now and in the future to meet the acceleration in the variety and number of health care needs. Urgently needed is drastic revision in the way needs are assessed and the way the functional roles required to meet them are assigned. Professional prerogatives, historial jurisdictions, and legal proscriptions which deter experimentation must also be reexamined in the light of social and individual needs.

Unfortunately, the factual and organizational substratum essential to rational solutions is not yet at hand. Instead, we must resort to empiric approaches which courageously and imaginatively scrutinize traditional patterns of care from two points of view: Do they serve the needs of patients


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