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July 31, 1967


JAMA. 1967;201(5):320. doi:10.1001/jama.1967.03130050054017

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In a variable function, a change in one dimension effects a corresponding change in others. When the lay society makes a change in medical care, a change will automatically occur in the profession which administers that care. Much of the turmoil within Britain's National Health Service accrues from the inevitable changes provoked in the physicians who serve it. The changes have not come about quickly; established physicians do not change radically. The newer crops, however, show the embarrassments of those trained to a new way of life by medical schools indoctrinated in the older.

Medicare will have the same ultimate effect in America. It will call forth changes throughout the medical profession, by no means entirely predictable. The physician, the nurse, and the hospital will change and not for the better, because they have mistakenly been supposed to be ever changeless. It is improbable that government agencies will be any