The biggest challenge is that we serve a membership and a public that are struggling to deal with a health care system that can be fairly described as dysfunctional. And it's not clear that the path of evolution today is necessarily toward a better system. But there's an opportunity in the middle of this. Get that transaction right. Make sure patients continue to have confidence that they have access to that sort of care.
Nothing jumps to mind as a particular moment of agony or triumph.
Instead, I think one of the successes of the organization is our steady progress along a number of fronts. For example, in a 10-year period we have essentially become wired, but it's been done in a stepwise, steady fashion. We have a tremendously active Web site, with participation by members and the public. We've also expanded our Washington presence. This has fostered a sense within the Washington policy community and our peer medical associations that the Academy is a central player on health services issues.