Dissatisfaction with Medical Practice

To the Editor: Zuger's article (Jan. 1 issue) 1 about physicians' dissatisfaction is fascinating but does not mention that health care is increasingly dominated by large organizations whose leaders may sometimes be incompetent, self-interested, and even corrupt. As power is concentrated in larger organizations, the ability of their leaders to do good or ill also increases. 2 Zuger quotes Ludmerer, but not his concern about “medical school and hospital officials [who] approached academic medical centers much as if those institutions were making cars or breakfast cereals.” 3 Multiple anecdotes about bad leadership have appeared in the local news media but are rarely mentioned . . .