To the Editor.
—While Drs McArthur and Moore1 identify the problem of professionalism vs commercialization in managed care, they refuse to consider the only intellectually or morally viable solution. The "two cultures" that they describe and delineate—commerce and professional care—are not just un-comfortable partners, but rather are essentially incompatible. One cannot really "care" for another individual if the reason for that "caring" is commercial. The result will be something, with some kind of commercial value, but it will not be the professional care we all have solemnly agreed to provide.If what we want, and I believe that it is what we not only want but desperately need, is professional patient-oriented medical care, then it must be separated from the commercial system that has no interest in human problems, of whatever cause or magnitude. Commerce just doesn't care—it cannot afford to do so; medicine does, and never in any inherently logical or