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August 1992

Cost-Containment and the Practice of Neurology: The Conflict of Canons

Author Affiliations

From the Robert Wood Johnson Medical School, University of Medicine and Dentistry of New Jersey, New Brunswick.

Arch Neurol. 1992;49(8):877-880. doi:10.1001/archneur.1992.00530320109021

During the past 25 years, dramatic changes in the practice of neurology have been nourished by major advances in basic and clinical neuroscience research, and the development of new technology. At the same time, it is difficult not to be concerned that the practice of neurology (and medicine generally) appears to be changing from a professional activity into a business.1 This is surprising, because medical practice has always reflected a blend of financial self-interest on the one hand, and the eleemosynary and solicitous characteristics of a profession on the other. However, professional obligations have traditionally outweighed business interests, collegial rather than competitive relationships with peers predominated, the ability to earn an adequate income in virtually any field of practice was assumed by medical students and residents (and so was rarely given much attention), and the intraprofessional status and prestige of the several specialties and subspecialties tended to be independent

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