That was very difficult for an integrated delivery system with an academic core. We both agree that doctors should make the medical decisions. We both agree that you should trust that your physician is going to act in your best interest, and not in the best interest of some kind of outside economic organization. So I think that philosophy is lining up. Doctors feel very much caught in the middle and unable to satisfy all those goals.
Doctors do feel as if their medical ethics are at stake.
It's in that situation that doctors feel like their ethics are at stake. So it's a battle of values. It's a battle of values, but it's not black and white. The truth is that there is some movement which can take place that will not compromise quality. But at a certain point, and beyond that certain point, it is an ethical and a mission problem.