ABSTRACT
The work of Everett Hughes has focused attention upon the crises which occur when existing institutions confront serious new challenges. 1 He has noted the processes of adaptation which must occur for the social fabric to be maintained. 2 The new orientations to community health care, and to consideration of family and community factors in health and illness, are providing a critical challenge to our health institutions. They are responding with profound changes, and the future form of the institutional network is still very much in doubt.
