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purpose but for reasons which the public probably does not understand. Many procedures could never have been developed if the surgeon had not enjoyed, not only the clinical facilities - which is to say, access to larger numbers of patients - but the immunity conferred by the clinic system. By this I mean that the surgeon is on a salary from the clinic and it is not directly paid by the patient. This means that the senior surgeon can offer necessary training to his resident or his fellow by allowing him to perform the surgery, whether the patient likes it or not. This is important because the resident or the surgical fellow has to have the opportunity to do surgery, not just scrub up and stand at the table holding a retractor while the chief removes the gallbladder or resects the stomach. It is also important for the development of surgery, that just as the patient pays the clinic and not the doctor, by the same token it is the corporate group and not the surgeon that he would sue if he were to decide that he had been mistreated. Potential malpractice suits are a powerful restraint and many operations would never have been worked out if the inventor had not had the protective situation of the clinic to support the innovation. This is of course not the reason why some people prefer a clinic to a private surgeon. They simply think that a well-known clinic will have only the most highly skilled surgeons on its staff. And perhaps they are carrying over into medicine the notion that you can be cheated by a man but not by a respectable bank. In any case, a good surgeon will be skillful and use his judgements, whether he operates in a private hospital or in a clinic one, and the important thing is that the patient was free to make his choice according to his condition."

  "Isn't he free to do that anymore?"  You have to remember that my

choice was made for me by the ambulance driver. And his choice