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October 8, 1997

Contempo 1997: Economics

Author Affiliations

Thomas-Davis Medical Centers Tucson, Ariz

JAMA. 1997;278(14):1149. doi:10.1001/jama.1997.03550140041028

To the Editor.  —As physicians who belong to the clinic and union discussed by Dr Reinhardt1 in his Contempo article on economics, we feel compelled to respond. We very much disagree with his economic and moral perspectives on the sale of our clinic and the appropriateness of our physicians' union.Reinhardt purports that the physicians who sold their clinic have violated Wall Street's "code of honor" by unionizing to fight proposed changes affecting patient care. By standing up for the rights of their patients, the physicians are not living up to their "moral obligation" to the acquiring company. Reinhardt somehow believes that the physicians have an obligation to the company (which, if anything, is an economic obligation, not a moral one) that eclipses the responsibility to their patients, which is the first priority of the physician and is inherent in the physicianpatient relationship. This is an erroneous assumption.Amazingly, Reinhardt also believes