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James S. Todd, MD

JAMA. 1992;268(1):98.

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

Success and progress always cause problems! Until fairly recently, the image of medicine was of a practitioner and patient working together in a spirit of trust and responsibility. Even with the advent of group practice, this same image persisted. Health care options, limited by a paucity of science, were simple and everyone understood the transaction. Then scientific progress quickened and the options for diagnosis and treatment exploded. Along with this began the isolation, through insurance, of both patient and physician from the economic consequences of their decisions. Following quickly was the escalation in costs of care beyond what some in society considered reasonable. Cost (really price) control was started, the intention being to reduce the volume of care given by reducing individual reimbursement: a shaky hypothesis at best.

Given this scenario, it is not surprising that physicians would look for ways to enhance the availability of all this burgeoning technology . . . [Full Text PDF of this Article]

Author Affiliations
From the Executive Vice President, American Medical Association, Chicago, Ill.

Footnotes
Reprint requests to American Medical Association, 515 N State St, Chicago, IL 60610 (Dr Todd).

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