This joint interview with Virginia Weldon, David Gee, and James O. Hepner of the Washington University Medical Center provides HCMR with a unique opportunity to capture the views of three nationally recognized health care leaders who are familiar with the health care issues facing one major health science center and one of America's great cities, St. Louis, Missouri. Dr. Weldon is Deputy Vice Chancellor for Medical Affairs at the Washington University School of Medicine and the immediate past chairman of the Association of American Medical Colleges. David Gee is President of the Jewish Hospital of St. Louis and serves on the Board of the American Hospital Association. Dr. Hepner is Professor and Director of Health Administration, Washington University School of Medicine and serves on the Board of the American College of Healthcare Executives.