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In a cycle of six commencement addresses delivered the year before he left office, of which this speech is the first, Koop sought to define his ethical legacy for a new generation of physicians who were entering the medical profession at a time of rising health care costs, managed health care, increasing disparities in access to health care, and AIDS. The physician's relationship with his or her patients and their families, a relationship that Koop himself had learned to cultivate during his thirty-five-year career as a pediatric surgeon, remained for him the key to the success or failure of modern medicine in improving people's health and longevity.