3

　　, is not common in most of the health-care industry.

　　In the health-care industry, the doctor-patient relationship is the mirror image of therelationship between producer and consumer. Once an individual has chosen to see a physician—and even then there may be no real choice– it is the physician who usually makes all significant

　　5

　　decisions: whether the patient should return “next Wednesday,” whether X-rays are needed, whether drugs should be prescribed, etc. It is a rare and experienced patient who will

　　6

　　such decisions made by experts or raise in advance questions about price, especially when the disease is regarded as

　　7

　　.

　　This is particularly in relation to hospital care. The physician must give evidence of the

　　9

　　for hospitalization, determine what procedures will be performed, and announce when the patient may be allowed to leave. The patient may be consulted about some of these decisions, but in the main it is the doctor’s judgments that are

　　10

　　. Little wonder then that in the eye of the hospital it is the physician who is the real “consumer.” As a consequence, the

　　11

　　represents the “power center” in hospital policy and decision-making, not the administration.

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