Following is my interpretation of a notice received from my Doctor this week:

Dear Patient:

You are a commodity; that is - an article to be used for trade leading to profit. I will (as much as I can) couch this in the utilitarian terms of a greater good, and I will (as closely as I can) follow the letter of the AMA ethical mandate for 'continuity of care' but the bottom line remains that you now have to pay to play.

For a nominal yearly fee you will become one of a select few (less than 20 percent of my current patient base) that I will generously allow to remain under my care. This will improve our business relationship by guaranteeing next day appointments, longer visits, more thorough examinations, and a greater focus (and this-time-I-really-mean-it attitude) toward preventive care and wellness services. Of course we have corrupted any previously established respect or goodwill by creating this market transaction, but the tradeoff is worthwhile: you can see more of me sooner, and I can work less for more money.

Please ignore the hypocrisy in the fact that your insurance will not recognize this fee and your Flex Spending Account cannot be used to pay it. I know in the past I have only allowed treatments approved by the Gods of Insurance, but you have the unique opportunity to snub your nose in their general direction by coloring outside their lines. Let's show them who's boss.

Some may say that by reducing your general health and well-being to the single market-driven question of 'who can pay?' I am ignoring morality, eroding personal values, and redefining justice. I maintain that the market has simply become the great moral equalizer ridding us of extraneous considerations and successfully widening the gap between those deserving of this good fortune and everyone else. You, my friend and future business associate, are deserving.

Yours Truly,

President and CEO
Doctor-Patient Mercantile and Trade