Abstract
In Reply .—Both of your letters are composed of an interesting blend of idealism and irony, a touch of sermonizing and satire, and a dash of humor designed to illustrate and to emphasize your point of view. We enjoyed the second version of your letter a great deal more than the first, which we have not published and which you felt I had misinterpreted as an attack by one specialty on another. We appreciate the effort you have put into this communication and agree with some of the points you make. Many of us can remember when advertising and marketing seemed foreign to the practice of a surgeon. The norm of the contemporary medical market place would have been grounds for censure by one's peers less than two decades ago. There is too much emphasis (in some regions) on the superficial trappings of a successful practice and too little effort given to
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