To the Editor I read with interest the Viewpoint by Dorsey and Ritzer1 and concur with their erudite observations. However, and unfortunately so, medicine and neurology have changed and will continue to change mercilessly, for better or worse, possibly the latter, while absolutely nothing can be done about it. Each of the 4 basic principles of McDonaldization in medicine can be argued favorably and I will play the devil’s advocate here. I will say that McDonald’s mantra will win in the end—if it has not already.