As much as I enjoy blazing new trails, my approach to this Presidential Address has followed the requisites faithfully taken by my illustrious predecessors. I have read the Constitution of the Association of American Physicians (AAP) developed in 1886, I have reviewed the history of the organization, and I have studied most of the Presidential Addresses delivered over the last decade.

Sometime in the mid 1970s, I recall sitting in the audience listening to the Presidential Address delivered by Hollie Smith. My thoughts at that time were transfixed on his brilliance, wit, and the glory of being the President of the AAP. Nonetheless, all things considered, I concluded I’d rather be in my mid-thirties and sitting in the audience. Little did I ever imagine that someday I would be addressing this august body with some thirty-something thinking the same thing about me. In 1886, the AAP defined its goals as the advancement of scientific and practical medicine, the development of a Society where like-minded physicians could discuss their work, and the creation of an association for colleagues who have made substantial contributions to the body of medical knowledge (Table 1). During the last two decades, our organization has undergone substantial change, and the introspection of our Presidents’ thinking about the contemporary role of the AAP is evident from the topics they presented. The dominant focus of recent Presidential Addresses has been oriented towards quo vadis—where is the AAP now and where should it be going? Many have wondered if it is indeed a viable organization. Most talks have focused on how much better things were during the good old days, the plight of falling memberships, and the risk for physician-scientists—particularly clinical researchers—to become extinct. During his Presidential Address in 2001, Dr. Robert Lefkowitz showed a chart (Figure 1)