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July 2, 1997

Professionalism vs Commercialism in Managed Care: The Need for a National Council on Medical Care-Reply

Author Affiliations

Harvard Medical School Boston, Mass

JAMA. 1997;278(1):21. doi:10.1001/jama.1997.03550010035024

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In Reply.  —Dr Murray-Garcia reemphasized that some physicians have acted with unprofessional greed in the past. In our article we clearly recognize the shortcomings of our medical history. All of us concerned with the problems of corporate medicine are well advised to recall that the corporate forprofit world of pharmaceuticals and hospital supply has coexisted with physicians, hospitals, and patients for about 200 years. We have suggested no change in this complex commercial relationship. Certainly we should have emphasized the threats to the care of minorities in our discussion of enrollment exclusion in the world of medical care.Dr Vietzke is strongly opposed to any accommodation to our guidelines for commerce as it invades US medicine. We believe this simplistic approach to be an abandonment of our patients' trust, and unfair to them, their children, and their children's children, as well as the future of US medical care. If we refuse to