Vol. 3 -- #17

  "Facing the Future in Medicine"
Presented& the John Warner Duckett Lecture
  Baylor University Medical center
        Dallas, TX
       March 30,1983

John Warner Duckett, a distinguished general surgeon from Dallas, had, after World War
II, entered the field of pediatric surgery and was apparently remarkably successful at it.
However, he declined to continue that as a specialty and contributed to pediatric surgery
in a much broader way by having his son, John Warner Duckett become the country's if
not the world's outstanding pediatric urologist.

I was responsible for bringing Dr. Duckett to Children's Hospital of Philadelphia after
Dr. Duckett had finished his training and completed the fellowship in pediatric urology at
the Hospital for Sick children at the Great Ormand Street Children for Children, London.

This lecture, a tribute in a sense to both father and son, is focused primarily on the
demographic and research environments of medicine. The demography of medicine, of
course, had to do with the "Graying of America" and the aging "baby-boom" generation
that was beginning to have babies of its own, the Echo Effect. In a sense this lecture is
quite prophetic about the problems of caring for the aged in the early years of the 21"'
century, as we are now experiencing.

The problems presented by the graying of America and the coming baby-boom echo
dictates the priorities in basic biomedical and behavioral research, which I addressed in
the remainder of the lecture. This is the first time I mentioned challenges in the future of
providing pediatric and geriatric care at the same time. Interesting that in 1983, I raised
the question about the choice of continuing the race down the road of the genetic
engineers, as opposed to investing primarily in virology and immunology.

The lecture concludes with the application of such research and the role of academia, as
well as the modern practitioner in priority setting in reference to medicine and research.
My opinion is that a passive role for practitioners is not enough and that the practicing
physician has to translate his or her understanding of the new science and its
ramifications for medical practice in some rank order and then relay those conclusions
back to the world of research. I recognized that this was not an easy task.
                   "Baby Boom" Generation
                    Biliary atresia

Bridges between research & practice
Cancer
Challenge of pediatric & geriatric care at

the same time

Demographic environment of medicine
Dilemmas of choice in urgent practices
Economic environment of medicine


Fertility rate
Genetic engineering
"Graying of America"
Heart disease
Infant mortality
Interferon
Neurotransmitters
Pediatric surgery
Pediatric urology
Practice of medicine informing of
   biomedical & behavioral research
Recombinant DNA

Centers for Disease Control
John Warner Duckett
John Warner Duckett, Jr.
National Institutes of Health