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July 9, 1982

The 'Growth Disease' in American Institutional Medicine-Reply

Author Affiliations

Northwestern Memorial Hospital Chicago

JAMA. 1982;248(2):173. doi:10.1001/jama.1982.03330020019019

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In Reply.—  I have had considerable correspondence from physicians concerning my commentary on "The 'Growth Disease' in American Institutional Medicine," but none from administrators or hospital board members. Mr Bader's thoughtful and incisive letter is, therefore, interesting and particularly welcome.It seems to me that the views expressed in my article, which reflect the thinking of most physicians I know, are strikingly consistent with Mr Bader's views. He states that there are reasons other than institutional growth that explain rising medical costs. I certainly agree. He stresses the need for controlling the ambitions of physicians for their particular vested interests. I certainly agree with that.Mr Bader approves of the "corporate governance model" that was outlined in the article and appropriately defines how to strengthen it and what its proper role should be. I have no disagreement. He stresses the need for effective management, and in this he is certainly