This article is freely available to all

Article Abstract
As professor and head of an academic department of psychiatry, I live daily with a paradox.

 

Our current, unstable, “nonsystem” of health care continues to lurch forward, buffeted by

 

many forces and lacking a strategic plan. The casualties include academic missions, stability

 

of clinical systems, and, most tragically, the well-being of people afflicted with illnesses

 

(and their loved ones).