It is a great honor and privilege to stand before you today to deliver the 2008 American Society of Clinical Investigation Presidential Address. I have chosen a controversial topic—and one that I know intimately—that challenges the standard operating procedures of our profession at many levels. While no one will object to the goal of applying basic biomedical research insights to clinical medicine, we can certainly debate the methods by which we encourage this process. Translational medicine has rapidly emerged as the rallying cry for many stakeholders in biomedical research, most notably the Congress and the public, who rightfully want to hold us accountable for their investment of taxpayer dollars into our enterprise. Major funding sources have channeled significant portions of their budgets into new translational research programs, many of which prescribe specific projects and even link delivery of resources to completion of defined milestones. Is this the best way to ensure bench-to-bedside science? Can translational research be directed from headquarters?

Before I begin that discussion, I want to reflect on the history of ASCI on our 100th anniversary, as there are many lessons in the past. As the story goes, ASCI was founded in 1908 by 8 young physicians, all in their early 30s (1). They had been regular attendees at the annual Association of American Physicians meeting, but were frustrated with the conventionalism of the old guard and eager to incorporate more science into medicine. In response they created the ASCI, a new society of young physician-scientists with a greater focus on the interface between science and medicine. Membership was restricted, as today, to those in the early stages of their