The incursion of business practices into our profession has made uncomfortable bedfellows of those with an avocation and those without. The union leaves our professions, especially the nurses, in a fragile state right now. If you derail the dignity and mission of what we do, we'll simply stop and do something easier. Indeed, it's happening. Nearly 150,000 nursing jobs languish unfilled today in the U.S. (We've already lured over every nurse that Ireland and the Philippines had to offer, and now we're recruiting in sub-Saharan Africa.) And these are good-paying jobs. There's a doctor shortage too — and those jobs pay even more.

What's wrong? The answer is simple: we've lost sight of that boring and corny moral imperative to do what's right for those in need, to love your patient as yourself. That approach has always driven good medicine. Not customer satisfaction.