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Daniel X. Freedman, MD
JAMA. 1987;258(16):2265-2267. doi:10.1001/jama.1987.03400160119032.
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Broadly evocative, the topic of education embraces the gamut and basis of professional functions. Thus, to educate and be educated as one apprehends the patient's problems and purposes demonstrates an essential professional purpose— long idealized as the physician-patient relationship. Yet, either to provide or to procure that bond and quality of commitment is increasingly problematic as physicians and patients face the rapidly shifting ad hoc arrangements through which medical care is currently sanctioned, sponsored, and delivered.

To keep even a thread of personal accountability in guiding the patient through the labyrinthine tortuosities of modern "health systems" demands an extra quota of dedicated effort. To educate means "to lead forth"—and while many still value this threatened ideal, the public's expectations of professionals are clearly in flux. Academia—itself increasingly, if unwittingly, "industrialized"1—mirrors this as it struggles with the true costs and needed personnel, resources, and sites for clinical education and


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