Numerous forces are presently deployed which threaten to produce largescale changes in medical practice and the systems of providing medical care. Some of these changes may be advantageous but others are likely to have deleterious effects on the quality of care, on the physician-patient relationnship and on the physician's freedom to practice as he sees fit. While certain of these pressures cannot be easily diverted, much can be accomplished with a modicum of effort to sway public opinion, the news media, the legislators and the bureaucratic regulation makers. Physicians, both individually and through their societies, must make this effort or suffer the pain of seeing immense decisions made without their leadership or intellectual guidance.
目前有许多力量在发挥作用，有可能给医疗实践和医疗服务体系带来大规模变革。其中一些变革可能是有益的，但其他变革可能会对医疗质量、医患关系以及医生按自己认为合适的方式行医的自由产生有害影响。虽然其中某些压力难以轻易转移，但通过付出一点努力来影响公众舆论、新闻媒体、立法者和官僚监管制定者，仍可取得很多成果。医生们必须单独或通过他们的协会做出这种努力，否则就会痛苦地看到在没有他们的领导或智慧指引的情况下做出重大决策。
