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Mr Schechter's response is appreciated. There is less disagreement in philosophy than he perceives. I neither justified nor defended the working conditions of present or past house officers. Neither did I argue for or against salary or other forms of compensation. Rather, the need is for concern, regardless of the setting today or in the past. The attitude of concern for house officers can be rationalized to another level if the employee-employer relation is the emphasis. Indeed, I argue for special attention to the circumstances of house officer employment, recognizing that the presence of compensation may create an adversarial environment in which personal problem-solving becomes very difficult.
Kettel LJ. House Officer Employment-Reply. JAMA. 1984;251(10):1279. doi:10.1001/jama.1984.03340340021014
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