I spent the last few days teaching a group of physicians who have made the commitment to acquire an advanced degree in business administration, in order to better face the challenges of the future of healthcare delivery in America. As if the rapid changes in science and technology did not present enough difficulties to busy doctors, the changes in the way insurers (including the government, the largest payer and driver of most of the changes) reimburse and evaluate the quality of care delivered by physicians is transforming the practice of medicine dramatically. It would be easy to give in to despair and burnout, but these doctors, some of whom were of my generation, but most younger, chose to devote some of their precious time to learning new skills and concepts that will better equip them for a new, uncertain world. To be sure, the changes are well-intended; paying for better quality, better satisfaction, and a higher degree of safety are things we can all understand and agree upon, but putting that into practice is challenging, to say the least. Based on my experience over the past four days, I would say that there is room for much optimism. I was impressed with the intelligence and courage of these students, who challenged the faculty’s teaching points and taught us as much as we taught them. And, in the midst of our conversations about payment systems, quality data, and patient safety principles, we returned again and again to the fundamental focus of healthcare delivery: the relationship between a physician and a patient who needs healing. So long as we stay focused on that, and with bright, brave, committed physicians like these leading the way, I think our healthcare system will navigate the future just fine.