[Horizons for Spanish respiratory medicine: reflections].

Respiratory medicine has undergone constant transformation since its beginnings as the medical specialty of phthisiology. Thanks to constant scientific and technical advances, and to their gradual adaptation to the needs of a continually evolving society in which respiratory diseases have changed in severity and prevalence, respiratory medicine is where it is today. The specialty has faced different challenges at different moments and the horizons that successive generations of Spanish pneumologists have looked toward have not always been easy to reach. The future will clearly be shaped to a large extent on the competence, vision, and the ability to respond to challenges of today’s specialists, who are the ones who will take charge. This paper, therefore, aims only to synthesize reflections on the horizons of the more or less immediate future of respiratory medicine. In an effort to organize the material, we have used a SWOT analysis—of our strengths, weaknesses, opportunities, and threats. First will come weaknesses, which are understood to be negative factors; if not controlled and overcome, they will represent obstacles to progress. Next, threats are aspects of our environment on which it is difficult to intervene; if they occur, they may also interfere with the attainment of objectives. Strengths are the attributes which can be relied upon to achieve growth. Finally, opportunities are circumstances that may arise around us. We cannot make them happen, but respiratory medicine will develop further if we are able to take advantage of them. From this perspective we might say that it is advisable to reinforce strengths with a purpose of taking the best advantage of opportunities that come our way, overcoming weaknesses in order to attenuate the effects of threats. Weaknesses