SCOTT GOTTLIEB: Modern Medicine Is Undergoing Industrialization. “The notion of the newly minted doctor who rents an office and hangs out his or her own shingle is a quaint reflection of a Normal Rockwell era that has expired. In its place, medicine is undergoing industrialization, where doctors are becoming owned commodities of large hospitals and health plans. This model was made largely inevitable years ago, with the passage in 1997 of the Balanced Budget Act. Under the Obama healthcare plan, it’s become the standard for the entire system. . . . The ACOs will fail because they aren’t premised on attracting investment to change how healthcare is delivered. They are just moving around the current pieces. Doctors will find themselves the pawns in this game. But it’s the patients who, faced with declining services and restricted access, will find themselves in checkmate.”

UPDATE: A reader writes: “One rarely-discussed aspect of health care’s industrialization is the impact it has on recruitment of new caregivers. How many people with a genuine urge to heal will want to spend their working lives in an industry fixated on bean-counting and bureaucratic control? And what sorts of people will want to work in that environment? And how will that impact the patient experience? Slower, please.”