In reply
I agree both with Steinberg's distress about supervisory "collegiality in the absence of accountability" and with his belief that medical academia can be blamed for the "deplorable turn of events."
I do not agree, however, that "entrenched" academicians are the exclusive "unsung culprit." The intellectual malady is extensive and complex enough to allow wide distribution for a multitude of blame. It can be shared by many other organizations and people: the National Institutes of Health, which inspired and funded the academic transformation; the educational accreditation committees that have approved the current deterioration; the leading professional societies, which have done essentially nothing about it; and practicing physicians, who have raised no outstanding objections to the educational process and whose chief complaints today arise from other phenomena: the corporate threats to professional autonomy and patient care.