In the current era of prosperity and economic boom, as more and more commodities are economically available to a wider population, Dr. Mason decries the fact that healthcare is still not financially possible for many Americans. He began practicing in Worcester 20 years ago, and remembers the public perception of the medical profession as very different from the contemporary one of cynicism and distrust. In the fifties, doctors were respected and revered for their knowledge and their quickly expanding healing capabilities. Advancing medical technology inspired the awe of Americans. Dr. Mason questions whether doctors are the villainous catalysts of their own public downfall, or whether they are victims of uncontrollable public sentiment. He argues they are both.
Physicians are the villains because they often allow themselves "to accept assignments physically beyond [their] own endurance." They tire themselves and thus curtail their abilities, not providing their best care to their patients. "We must learn individually and as a profession to discipline our energies and time, for the fatigue that comes from service can be destructive to both patient and physician and can lead to malpractice and poor judgement." Unscrupulous doctors also add to the profession's villainous character: "a physician is given the opportunity to achieve levels of gratification and pride of accomplishment that is granted to few human beings and if financial reward is of more importance than that our profession is indeed the villain that our enemies say it is."
Mason's suggestions are for physicians to review their colleagues' performance themselves, that they should take the initiative to continue their medical education, rather than doing so to meet requirements set by non-physician groups.
Dr. Mason criticizes the American public for focusing on the cost effectiveness of medical care. Although they complain about excess equipment and overuse of expensive procedures, they lose sight of the fact that these are medical expenses and systems of limiting expenditures cannot be applied as they are outside the medical realm. Mason answers the public's outrage at bearing at least some part of medical costs by pointing out that we think little of spending the same amounts of money on leisure goods and services, saying that we are "a nation or a people who are overwhelmed with a need for creature comforts but are not really sensitive to the sufferings of our fellow human beings."
Physicians are victims of a reimbursement system that asks them to limit their use of expensive treatments to their young patients who will have a longer-term benefit. This suggestion goes against the basic principle of medical practice. Mason calls on his colleagues to get involved in fighting legislation that is "detrimental to patient care." If they do not, they have earned their reputation of being apathetic and passive participants in the evolving world of medicine. Doctors have conspicuously been absent from the groups that have been formed to handle medical care costs, which is unacceptable and irresponsible as "the health care planners cannot undertand as [doctors] do the pain and suffering of human beings in the grips of illness." Instead of taking an "elitist" stance, physicians should recognize the expertise of their "non-medical colleagues" who have skills and information that can be helpful to medical personnel in developing healthcare systems.
Dr. Mason predicts that future doctors will need to practice in groups in order to provide their patients with professionals knowledgeable in all aspects of medical treatment. But he is quick to point out that "that which is cost effective& is not always the best nor the most humane" and "let us hope that people will continue to moderate economy with humanity."