The themes developed by the American and British participants, however, ranged much wider than the historic transatlantic connections. Current dilemmas of American and Scottish medicine are strikingly similar despite the differences in formal structure, being increasingly concerned with public policies and the influence of government on medical care.
Emerging on the American scene are problems well known in the United Kingdom, since the advent of the NHS but not a result of it: the pressures of rising costs, the pressures for equity of access and service, the pressure from central government for the development of controls on costs, on manpower, and on professional standards, the seeking through better organisation for economies against an ever-rising bill for personal services. The philosophy of wider public participation raises special problems of administration in democracy on both sides of the Atlantic.
The position, therefore, of the supplier of medical care is highly charged with new responsibilities which demand responses in medical education.