Founders-Sumner lecture.

The revolution in patient care financing and in the structure and changing scope of the health service system calls for leaders in health care to address existing challenges in the health delivery system. Medical leadership cannot ignore, much less resist, the challenges inherent in the flux and dynamic changes going on in the medical care/health sciences environment. Some of these changes are fueled by fundamental advancements in science and technology. Other developments are fueled by political, demographic, economic and social forces. This article highlights some of these challenges and urges the medical leadership to assume the obligation to assure quality of health-care services and not allow it to be over-shadowed by market forces.