Recently, a number of articles have been published concerning the future of the discipline of pediatrics.1-5 These articles reflect a growing concern among those who care for our children that societal forces are impinging on the fabric of pediatric practice and that not all of these forces are benign or friendly. The report in this issue of The Journal by the Council on Long Range Planning and Development of the American Medical Association, produced in cooperation with the American Academy of Pediatrics, is the latest in this series of analyses.6 It carefully catalogs some of the most critical societal influences as objectively as possible. The report also makes recommendations for action by organized medicine in response to these influences. The report is admirable in its description of the problem, but less satisfactory in offering tangible solutions or approaches.
The major societal impact on pediatric practice and child health