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By John D. Lantos M.D.

Written with poignancy and compassion, Do We nonetheless Need Doctors? is a private account from front strains of the ethical and political battles which are reshaping America's wellbeing and fitness care process.

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We were supposed to take St. Lo on D plus two. But we couldn’t get through the hedgerows. ” I asked. ” Quickly. He didn’t look at me and he didn’t really look away either. His hands seemed to have a little tremor and his eyes went sort of blank. I wondered whether he was lying or whether he was remembering a time when he had killed a man, whether he remembered being scared. His memories never had any real emotion; they always seemed ironic, distant, absurd—memories of things that happened to someone else, a character in a movie, Forrest Gump.

He didn’t like questions. With him, the story was the story, and when it was over it was over. Six weeks after landing with the second wave at Omaha Beach, he sustained a major shrapnel wound to the hip and POSTWAR OPTIMISM 21 elbow in heavy fighting near Brest. In one of the most efficient medical triage operations ever devised, he was flown back to Britain and operated on the next day. After three months in a rehab unit, he was sent home with a Purple Heart. One leg was a little shorter than the other, and he’d never play college basketball, but it could have been worse.

Each tiny element of care became a profit center, and each doctor who could monopolize a procedure became a player. The nature of medicine changed. High salaries became the norm, and to generate the revenue, doctors needed to generate clinical volume. “Productivity figures have become the name of the game,” reported one doctor at Marshfield. “In prior years, administrators were the servants but now they are in command. Reprimands or reductions in salary may follow failure to meet predetermined norms.

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