The primary care doctor is a rapidly evolving species — and could become an endangered one. As we grapple with making health care more widely available and reducing its cost, it's hard to say how primary care physicians will fit into emerging delivery models.

Paternalism in discussing resuscitation status has given way to an approach in which patients may be asked to choose from a bewildering array of medical options, but physicians-in-training are rarely taught how to lead such conversations confidently and effectively.

Medical education in this era of a vast medical canon can be improved without increasing the time it takes to earn a medical degree, if we make lessons “stickier” and embrace a learning strategy that is self-paced and mastery-based and that boosts engagement.

Much progress has been made in applying scientific evidence to medical practice; less progress has been made in rendering care “patient-centered.” A five-step framework for reconciling the tension between “evidence-based” and “preference-based” medicine may help.

Disparate voices are advocating changes to Medicare's investment in graduate medical education (GME) — now $9.5 billion annually. Prescriptions include reducing federal support, developing performance measures, and assessing programs' governance and financing.

In addition to disseminating new knowledge, medical journals define the scope of medical concerns and articulate norms for physicians' professional and social roles. The history of NEJM provides a window on the changing functions of journals and the medical profession.

Beginning in 2015, the Medical College Admission Test (MCAT) will include sections on behavioral and social sciences and critical analysis and reasoning. These revisions reflect the recognition that behavioral and social factors play major roles in health and illness.

U.S. medicine may have reached a tipping point in limiting industry involvement in continuing medical education. Progress appears to be accelerating, and further restrictions are likely to become more widespread, thanks to shifting norms in the culture of medicine.

As the United States struggles to emerge from an economic crisis, policymakers and the public have homed in on skyrocketing health care expenditures. What lessons can be drawn from the evolution, since 1950, in sources of payment and objects of expenditures in health care?

A medical student working at health fairs and clinics in underserved communities spends his time asking people what their lives are like — but can't truly empathize until his own father loses his job and his health insurance.

The relationship between patients and doctors is at the core of medical ethics, anchoring many important debates in the field. Over the past several decades, this relationship has evolved along three axes — as it is defined in clinical care, research, and society.

Whereas effective treatment for noncommunicable diseases may be too costly to disseminate globally, opioids for pain control are cheap to produce. Yet 80% of the population, including millions of patients with terminal cancer, lacks adequate access to pain treatment.