>>>Yes, the patient is accountable - but at what cost?
>>>Since there is no apparent cost to the patient, there is no restraint.
>

>>IMHO physicians face a perfect storm of second-guessing insurance clerks, ambulance-chasers
Everyone in any profession faces choices.
I can bill fairly or choose not to. I can buy cushy projects or choose not to.
You either have ethics or you don't.

>Seems to me the best person to be put in charge of the $ is the person who wants it least- which used to be and in many countries still is the physician.

You've said many times- and I've quoted it (with attribution) that the animal is always right.
Why not let the animal - aka facts- decide.
We can start my taking away all the hocus pocus and voodoo rituals and telling the patient what is really going on in plain English (no Latin nonsense)
For example-
Call an ophthalmologist an eye doctor.
Call a podiatrist a foot doctor (better yet, a toenail clipper since most of them spend their days clipping toenails)


BTW - I'm proud to say that my elder grandson - Dillon McNamara Fitzgerald will probably start pre-med studies in September and he'll be someone who will get it right (of course!)