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Daniel X. Freedman, MD

JAMA. 1980;243(21):2208-2210.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

The past decade has encompassed momentous attitudinal and regulatory challenges to post-Flexnerian medicine, especially to the governance of its practices and priorities. Issues of costs and equity clash, obscuring concerns for professionalism, physicianship, quality of care, and the knowledge base on which all this depends.¹ Thus, perspective on the psychiatric components of our knowledge base, and the skills available both to psychiatrists (the future supply of which is in doubt²) and to general physicians (who may see 60% of known mental disorders^3,4), may be particularly difficult to sustain.⁵ This derives from the very nature of these disorders (striking at fears of lost competence and personal autonomy). Distracting, too, is their span, ranging from acute distress to distinct syndromes and diseases that not only engender a significant excess of morbidity^6-8 and mortality,^9-11 but a small, although highly significant incidence of socially compelling chronic impairments.¹² . . . [Full Text PDF of this Article]

Author Affiliations
Chicago

From the Department of Psychiatry, University of Chicago, Chicago.; Member, editorial board, The Journal.

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