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As the 21st Century unfolds, although great progress has been made in the diagnosis and treatment of many medical conditions, many key national health indicators demonstrate dramatic worsening in the health status of Americans. An epidemic of obesity and Type 2 diabetes are sweeping the nation at an alarming rate. Depression and stress continue to be prevalent, yet are often left undiagnosed.  … many key national health indicators demonstrate dramatic worsening in the health status of Americans.  As physicians rise to meet these health challenges, they are faced with the reality that the practice of medicine is continuously becoming more demanding. Advances in the science of medicine and increasing requirements for performance improvement challenge physicians to meet higher and higher expectations. Permanente physicians are now experiencing the most dramatic changes in the last 50 years.  To address these challenges, many organizational initiatives have been developed. Permanente physicians are supported by an extensive network of health professionals such as care managers, dietitians, psychologists, and health educators. An extensive library of patient health information is available on the Clinical Library Web site, physician home pages, and at health education centers. Many health education classes are available. The Healthy Beginnings Program for pregnant women and the Menopause Guidebook are available to address the needs of our women members. The physician home pages, patient lab letters, and Preventive Health Prompt have demonstrated that information technology can be used to improve the quality of care while at the same time making health care more personalized and efficient. The KP HealthConnect and www.members.kp.org Web sites represent the next evolution of these programs and a breakthrough in the integration of information technology and health care.  Despite all these initiatives, some physicians and patients describe their lives more in terms of surviving than thriving, and many of the tools, services, and programs available are underutilized. To thrive is defined as to prosper; to flourish; to be successful especially as a result of industry, economy, and good management. The integrated systems, innovations, and programs of Kaiser Permanente (KP) give KP members and Permanente physicians the opportunity to thrive if one chooses to use the tools and services described. In this journal, numerous innovations and educational approaches to improving care are described. The Teen Choices and Challenges Program represents a potential breakthrough in reaching teens and young adults. The Early Start and Family Violence Programs have been nationally recognized as model programs. The Primary Care Conference is an opportunity for Permanente physicians to keep up to date with the latest innovations and to network with other Permanente physicians. With all of these tools and services available, thriving as a physician or patient is simply a matter of choice.

Can Patients and Physicians Thrive in the 21st Century?