Do the right thing. When it comes to your community, do you know what that is? Roundtable discussion.

What is the health care organization's responsibility to maintaining a healthy community, and how does the board fit into that role? Has the field's understandable fixation on costs and the penetration of managed care into most markets affected that role? Leaders of both for-profit and not-for-profit organizations often believe that they are fulfilling their community obligations as long as they provide uncompensated care to the indigent and the uninsured. But is that really being accountable to the community? And if it's not, then what is community accountability? The American Hospital Association's Division of Trustee Leadership and Trustee magazine posed these questions to 13 health care and community leaders last December. Their different perspectives provide for some surprising answers.

Undergraduate medical education in prepaid health care plan settings.

The authors in this article focus on prepaid health care plan (PHCP) involvement in undergraduate medical education and report the results of two surveys undertaken to determine the extent of such involvement. Additionally, the authors provide a review of published studies that have examined the costs of such training. The survey findings show that current use of PHCPs for educational purposes is distributed throughout all four years of undergraduate medical education and is apparently on the rise. In addition to 26 medical schools reporting formal educational arrangements with health maintenance organizations, 35 other schools indicated that they either planned or were seriously considering such arrangements with PHCPs had ongoing ad hoc arrangements with PHCPs, or attributed their lack of an arrangement to an absence of appropriate opportunities rather than to any conceptual reservations. Three studies represented the extent of the published research that could be identified on the costs of formal undergraduate clinical training in PHCPs. Serious inconsistencies in the methodologies employed in those studies resulted in widely varying and even contradictory findings.