Abstract
"The situation regarding the care of chronic disease in this community is such that certain measures must be taken in the near future to improve the conditions if Boston is to retain its place as a progressive medical center,"1 cautioned an editorial in the Boston Medical and Surgical Journal in 1906. A similar concern, even more dramatically stated, was expressed in a recent issue of the New England Journal of Medicine, the direct descendant of the Boston Medical and Surgical Journal: "Of all the difficult health-care issues facing the nation today, none is more complex or more urgent . . .