I would like to thank Steinberg for his thoughtful comments concerning my recent editorial in the ARCHIVES. The main thrust of his letter is that American medicine is suffering today because of past sins of greed. Under the fee-for-service system, Steinberg believes that we tested and treated excessively since it was in our economic interest to do so, a strategy that he terms "maximalist medicine." He is particularly hard on academicians (especially department chairmen and division chiefs) who even today "are making outrageous salaries" and who "are not in the least interested in reducing the cost of medical care by limiting the number of unnecessary procedures."
Alpert JS. Entrenched Medical Academia as a Culprit. Arch Intern Med. 1998;158(16):1827-1829. doi: