HEALTH CARE in America is in transition and, as Richard Sontheimer's1 glossary of health care economics clearly and often humorously points out, academic dermatology departments are full participants in this very difficult process. As the 20th Century closes, the role of academic medical centers in the American health care system remains clear. Just as they do now, these centers will continue to bear the responsibility for education of the next generation of physicians and most other health care providers. However, the level of resources available to meet this mission is decreasing, and policy with regard to the level of future resources is unclear. Without question, dermatology and dermatology training programs will be altered by the changing health care system.
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