Undeniably, medicine is in transition. Dr. Gladston has produced a remarkably perceptive, objective analysis of the problem "Whither medicine?" In an incisive opening chapter the breadth and complexity of the issues impelling transition are set in historical perspective. He states, "Medicine is less the master in its own house and is to a lesser degree the captain of its own destiny now than... ever... in its long history," and then he admonishes medicine to perceive its future by viewing "its own destinies in the perspective of the larger social dynamics," rather than looking only to matters internal to medicine.
The important role of economics, the socioeconomic structure and the prevailing temper of the community are recognized and analyzed—in both a macroeconomic sense and a microeconomic view of the hospital, the medical practitioner, and the drug industry. Galdston draws attention to the important distinction between medical economics, over which the physician