Quality and efficiency (including changed quality requirements, increasingly scarce specialist staff, increasing the number of cases with decreasing length of stay and postponement of performance), ethics and economy (among other things Increasing cost pressure, decreasing profitability reserves, capacity reduction in acute care vs. capacity expansion in the outpatient/inpatient sector) as well as tradition and progress (including changing patient requirements, integrative care, outpatient before inpatient), which are dealt with discursively during the course.