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Philip R. Alper, MD

JAMA. 1985;254(19):2799-2800.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

THERE is an apocalyptic ring to most characterizations of change currently taking place in health care. Representatives of government, the insurance industry, forprofit medical entrepreneurs, and various health planners and consultants in and out of academia are united in predicting the demise of fee-for-service medical practice. Solo practice, in particular, has been targeted for extinction.

"Competition" is the byword of the day. Under this rubric, an avalanche of hype and exaggeration has descended on the medical community. If we are befuddled, it is deliberate. The principles of marketing, advertising, and business advantage are so alien to our medical-science backgrounds that what is being asked of us is akin to learning to mix oil and water.

To practicing physicians like myself, the future would seem bleak indeed. Yet, there is so much talk about what "will be" that it is easy to forget what actually is. Both fee-for-service and solo medical . . . [Full Text PDF of this Article]

Author Affiliations
From the Department of Medicine, University of California at San Francisco School of Medicine.

Footnotes
Reprint requests to 1838 El Camino Real, Suite 102, Burlingame, CA 94010 (Dr Alper).

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