Ambulatory care--1990: a view from the trenches

In summary then, many of the changes that have accompanied the massive shift to outpatient care in the past decade have been good. However, change itself is not inherently good, and the effect of change upon the individual physician is extremely important. In my opinion, the increasing hassle, overregulation, and second guessing that have accompanied recent changes have had a significant negative effect upon physicians. The signs of this happening are clear. This in turn does not bode well for patients and the quality of medical care that will be available to them in the future. I would submit that the focus of any scrutiny of the benefits of changes in our medical care delivery system should be the practicing physician. The impact of such changes upon physicians and their ability to carry out their mission of patient care will provide our best guide for the course that we choose for our future.