The mission of a physician hasn't changed. We are trained for years to do whatever we can for others to the best of our ability. I will never sell out to bureaucrats who haven't had my 11 years of medical training. If that means dropping all government and private insurance plans, so be it. We are trained to think independently and practicing medicine is a complex interaction that can't be reduced to a cookie-cutter approach. The ACA will wreak havoc on American medicine, including the unwarranted transition to electronic records that are not ready for prime time. We have always been patient-centric, though others don't seem to think so.

Those of us around for 2 or 3 decades inadvertently helped create this debacle by giving small discounts to insurance plans that turned into unsustainable reimbursements. It is young doctors who think private practice is impossible who need to be encouraged and supported in networks demonstrating that fee for service private practice can rise again and flourish. Physicians ultimately hold the best hands and our patients deserve the kind of care we were trained to give. Where there are big groups owned by hospitals, there should be many openings for practitioners who provide better service to blossom.