Dramatic change has occurred in the last decade with marked impact on the delivery of health care in this country.

First, the process of business has changed with dramatic alteration in business practices and goals. Thirty years ago, landing a job with Kodak was a life commitment by the worker and the employer. Now it is only a contract worked out between willing participants, possibly with a 90-day escape clause for some parties.

This cold, sharp process has invaded the realm of medicine, deeply impacting hospitals, insurance companies, governments, and particularly the physician.