In 1988, an exciting and important new program was launched at the Institute of Medicine. Through the generosity of the Richard and Hinda Rosenthal Foundation, a lecture series was established to bring to greater attention some of the critical health policy issues facing our nation today. Each year a subject of particular relevance is addressed through a lecture presented by experts in the field. The Rosenthal lecture included in this volume captures three exciting presentations, given by Drs. Elliott Fisher, George Isham, and Lucian Leape, and reveals the ensuing discussion on "Next Steps Toward Higher Quality Health Care."