Thirty-four years ago, during my senior year in medical school, one of my professors published a book. It was called Medicine at the Crossroads.1 One needs to read only to the second page of the "Foreword" to learn that it concerns the "crisis" in medical care, and that if the profession does not voluntarily mend its ways the government will take over. Apparently, in the view of some, my contemporaries and I have lived our entire professional careers, either stalled at the same crossroads, or impaled on the sharp point of a crisis, depending on one's choice of metaphors. Somehow or other, it hasn't really seemed that way.
A 34-year-old volume on the socioeconomics of medicine is scarcely a source for currently valid statistics. How quaint it may seem is apparent from the fact that the high cost of medical care is equated to $4-a-day hospital rooms and to