Each year at this time the President is privileged to address theSociety on a subject that he hopes will beof interest to members and guests. After giving much thought to the matter, I have decided that the most important problemfacing academic medicine today is the question of our relationship to government and to the public that it represents. Stated in the briefest of terms, the issue is how we ought to respond to the pressures being generated by a changing social climate, inwhich federal support for research seems to be threatened, and demands for more services and community involvement are coming from all sides.

This I believe is the problem that is causing us the greatest anguish these days, and this is the problem that I want to discuss with you this morning. Let me confess at the outset that I have no claim to any special wisdom in thisarea, no solutions to pro-pound, and, in fact, no confidence that there are satis-factory answers to the problems we face. Nevertheless I believe we must examine the current situation as closely as we can. Unless we do we may lose by default any opportunities to influence the future direction of affairs.