On February 28 and 29, 1992, the Council held a two-day retreat in Bethesda, Maryland with the current officers of the Society, the former Secretary-Treasurer, four former presidents and five additional members chosen for their expertise in specific areas. One member invited for his expertise in preventive medicine, one officer and two councilors were unable to attend; two of these four submitted written comments. The purposes of this commentary are to explain the rationale for the retreat and to outline the major issues that were discussed. During the next 6–8 months, there will be a series of commentaries in the Journal. The purposes of these commentaries will be to inform the members about the issues that were discussed, and about their potential impact on the Journal, the annual meeting, and the other activities of the Society.