Staying the course.

Much has been written about public hospitals relative to their mission to care for the underserved, their role in medical education, and the continuous financial challenges that they encounter. But, despite doubts about their viability, public hospitals have not only withstood the test of time, but have thrived and have evolved into a new entity, i.e., the safety net hospital. Like with any long-standing institution, the development of public hospitals holds valuable lessons that provide insight into how they will continue to evolve and potentially strengthen, even in the face of adversity. Their rich heritage includes many medical "firsts" in the United States such as the first municipal ambulance service, first blood bank, first trauma center(s), first cardiac catherization, and first civilian burn center. If safety net hospitals care for their communities and continue in their educational mission, they will thrive in the tradition of service.