This concluding chapter examines the implications of system accidents, high-technology medicine, and a corporate health care system in terms of medical malpractice claims and health care in general. Although I have acknowledged the importance of cultural and legal factors in influencing claims, the accounts in this study point to a more fundamental problem in the very focus and organization of medical care. The deck is stacked against the health care system since it has placed its focus more on treatment than on patients. Although training can help refocus care on patients, medical specialization and technology are demanding partners. They require a great amount of capital and attention to detail in order to be properly implemented, and this comes at the expense of establishing a personal rapport with patients. People who are highly motivated to master medical technology do not have the time or willingness to establish close ties with their patients. Furthermore, even when high- technology procedures are carried out properly, unintended consequences may result because there are always opportunities for unanticipated interactions within the patient's body that result from the complex array of drug, medical management, and technology effects.
Four major implications are raised in the preceding pages; all but the first are related to public policy. The first implication is that medicine's professional dominance has declined. Physicians no longer enjoy the professional status they once did, either at the clinical or professional levels. This makes it easier for both administrators and alternative healers to