By Eric E. Shore, DO, MBA, FAAFP

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To quote Dylan, "the times they are a-changing" and we must change, adapt, or be left behind with the dinosaurs. The role of the physician is as it has always been—to cure disease or, failing that, to at least relieve suffering. It is only the environment within which we are allowed to pursue our jobs that is changing. What Dr. X fails to realize is that Medicine has been "behind the curve" in this change. It hit most other businesses sometime between the Industrial revolution and the 1950's. It was our own failure to see the future and either change it to one that we felt was appropriate, or adapt to it, that has left us feeling disenchanted, disenfranchised, and powerless, when nothing could be further from the truth.

The profit in healthcare is no longer in the clinical practice of Medicine, but it is that very practice that is the sine-qua-non of the entire industry. With a proper approach to the managed care companies and vertical health organizations, much of what we seek can be achieved, while still allowing us to practice our profession and recapture that sense of pride and satisfaction in what we do. We are not involved in the "zero sum" game that has been forced upon us thus far. It is really a win-win situation if properly managed. Let's hope we take the proper approach, with judicious use of both the rod and the carrot, before all of the dire predictions come true.

Power is taken, not given.