DR. Donald Seldin, Moderator: Whatever else the health-care system involves, it involves a confrontation between a patient and a physician at some time. This interaction has many intricate features and is rather fragile. Dr. Halberstam has emphasized that this interaction should be warm and humane despite the cold impersonality resulting in part from the enlarged technology and personnel required for the management of certain illnesses.
Still, many aspects of this interaction are complicated. Some patients are really not ill; they are what has been termed the worried well. It seems inefficient and wasteful for a well-trained physician to devote extensive amounts of time to an individual who might better be handled in another manner. At the same time, the interaction is a valuable one, and Dr. Schwartz has pointed out that it is sensibly reenforced by various payments that are funneled from patient to physician, the fee-for-service system.