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To the Editor.—
Can a federally imposed bureaucracy really improve the quality of medical care? Consider, by analogy, the consequences of a bureaucratic body economy as depicted in the following "case report."Scene: The urinary bladder.Mast Cell Bureau (MCB): "A small number of E coli have gained entry to the bladder interstitium in the area of the trigone. Histamine release and alterations in capillary permeability cannot be effected until the accused invaders have been duly informed of their rights as aliens."Fixed Tissue Macrophage Agency (FTMA): "We confirm your observations, MCB, and in accordance with PL50-1065 will dispatch leukocyte promoting factor (LPF) to the Central Bone Marrow Commission (CBMC) for recruitment of leukocyte aid, pending further action on alien status of said E coli."CBMC: "This is a recording. Your request for leukocyte release and synthesis is being taped and will be considered as soon as the Bone Marrow
Frascino JA. If My Body Were a Bureaucracy. JAMA. 1977;238(12):1247. doi:10.1001/jama.1977.03280130029003
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