Health care around the world is beset by

• rising costs
• declining access
• stagnant quality
• increasingly dissatisfied health care professionals.

Physicians fear their core values are threatened.

These values include:

• putting the interests of individual patients ahead of other concerns;
• practicing with honesty and integrity;
• keeping patients' information confidential;
• teaching the next generation of health professionals;
• practicing medicine based on science and scientific principles.

Strong but generally unrecognized threats to these values arise from concentration and abuse of power in health care systems, because:

• health care is increasingly dominated by large organizations;
• these are often lead by the ill-informed, the self-interested, and even the corrupt.

Thus, the results are:

• patients and physicians are caught in cross-fires between conflicting interests;
• patients and physicians are subject to perverse incentives;
• free speech and academic freedom are threatened;
• pseudo-science and anti-science are gaining ground.