This is the House of Medicine. Shall it be a House united, or a House divided? That, in my judgment, is the central question before us at this moment in our history. Shall we as a profession continue to speak, through this House of Medicine, with one, strong, effective voice, or shall we succumb to the festering factionalism that can only serve to diminish that voice? That is the choice we face, that is the decision we must make. Factionalism in our profession springs from a number of causes and assumes a number of forms. First, let us examine some of the causes. The state of mind of most physicians today is one of profound disquiet growing out of the threat we feel each day to our profession. Almost daily, there are new infringements on the way we practice—intrusions by government and by other third parties. Almost daily, there are