Abstract
Once upon a time doctors had nearly complete professional autonomy. If they completed their training, were licensed by the state, and were certified by a professional board, they were assured the respect and trust of the public, and virtually no one kept track of their professional performance. What a difference a few decades make! Today, doctors' everyday decisions are regularly scrutinized, monitored, and regulated, and their judgments about individual patients can be overturned by nameless employees of third-party payers. Many physicians are concerned that recent approaches to quality control, such as practice guidelines and appropriateness studies, will regiment them even . . .
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