One reason frequently given by young physicians for not wishing to practice in rural and semirural areas is that there are no hospitals, laboratories or medical libraries available there. To the modern, well trained doctor the value of all three to the adequate care of the patient is obvious. American medicine has reached its present high position, in part at least, because of the ability of American physicians to adapt the standards of the past to the changing needs of the present and to build on the firm foundations of what has gone before.