Summer 1996

The Future of the Hospital

by C. Everett Koop

What the hospital might look like 10 or 20 years from now.

Back in medical school, when my eyes would become tired and sore late at night after hours of peering through a microscope, I would often take a break by walking to the middle of the Queensboro Bridge, where I would gaze into the distance at the lights of Manhattan or at the stars overhead. Looking far away was a welcome change, and it also gave me a better perspective on my work.

In more recent years, since leaving my post as surgeon general in 1989, I have devoted myself to the challenge of health-care reform. Traveling throughout the United States, I have spoken out on the ethical imperative of reform and offered concrete suggestions about what we need to do. It has been a formidable task, often requiring intensive, almost microscopic examination of the many problems within the American health-care system. Thus, the opportunity to look into the distance, into the future, to try to get a glimpse of what the American hospital might look like 10 or 20 years from now, comes as another welcome change. Yet the images I see are more kaleidoscopic than telescopic: intriguing but always shifting, often reflecting the past as much as projecting into the future.

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