In this issue ofThe Journal, we publish the first in a series, Health Care Policy: A Clinical Approach. The series is written by two physicians, Thomas Bodenheimer, MD, MPH, and Kevin Grumbach, MD, both associated with the University of California—San Francisco. Most clinicians my age (58) will have had no formal training in health policy. Indeed, 30 years ago, if I had been asked what my policy was on health, I would probably have replied that I was for it and, if pressed, would have asserted that my policy was to do what I thought was best for my patients. These replies are still appropriate today, but not sufficient. When we went into medicine, my colleagues and I were prepared to accept the responsibility of caring for our patients, of explaining their symptoms and signs, and of alleviating them in ways that accorded with the best available evidence. And
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