The science and technology of surgical care has clearly outgrown society's ability to afford it. Yet, like the financially irresponsible teenage son of a rich family, we as a profession continue to spend as though our rich uncle will never tire of providing us cash. Clearly, this is not so, and the day of reckoning will soon be on us.
Most surgeons who bear the responsibility of teaching have in the past ignored the problem as inappropriate to their cloisters; however, the nonteachers as a group are perhaps equally to blame. Though more alert to the economics of practice and surgical care, they have been more prone simply to blame the problem on inability to collect justifiable patient care costs from third-party carriers. The problem is, of course, far larger than devising more effective means of squeezing reimbursement costs from the government or other insuring agencies. Necessary though this may