With the increasing demand for and cost of medical care, policymakers recognize the need to reconsider the organization of health care in the United States. Any reordering of health care priorities will focus on providing optimum care at minimum cost and can only advance the role of general internal medicine. During the past year, research relevant to general internal medicine focused on several issues: (1) more cost-effective approaches to diagnosis and treatment of common clinical problems using low-technology approaches that include the clinical history and physical examination; (2) the role of gender in medical care, focusing on women as physicians, patients, and subjects in research studies; and (3) internal medicine manpower overall and general internal medicine specifically. Multiple research reports have documented the utility of routine clinical observations for establishing diagnoses and targeting therapies for common clinical problems. JAMA has even begun a new series of articles called the "Rational