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1. What do you consider the most important trends in medical practice in the U.S.? Discuss at least three major trends, and provide your assessment as to whether these are positive or negative trends for medical care in our country.

2. Much of the surgery once performed at American hospitals is now done at ambulatory surgery centers (ASCs) across the country. This trend has certainly made hospital CEOs unhappy. Surgery has historically been one of the most important revenue drivers for hospitals, and that revenue is now going to the owners of the ASCs. Why are patients in favor of ASCs for surgical patient care? Are they good for patients, or should surgery still be done in the hospital where full emergency services are available in the event that something untoward happens to the patient on the surgery table?

3. All over America today we find medical professionals who are busy; in fact, they are increasingly busy as the Baby Boomers are reaching Medicare age and finally getting their health problems addressed. Sometimes these are health problems that really should have been addressed a few years back, but evaluation and care were delayed due to lack of coverage.

Meanwhile, even though caregivers are busier than ever, most hospitals have empty beds-sometimes lots of empty beds. Why is that? What are the key factors that have driven U.S. health care outside of the inpatient hospital into ambulatory care settings? If the inpatient hospital is empty, where do we find our patients these days? What specific types of facilities are providing more care than our hospitals are providing today?

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