title: A reply to the comments on The Condition of Surgery.
abstract: Any system of allocation of services works more efficiently in the consumer's interest when there is competition among suppliers of the service. But this same competition reduces income and options of sellers. Professionals-as-sellers are likely to resist competition by restricting entry into their ranks and the range of qualities to be offered. An informed consumer should be allowed to exercise discretion in choosing among qualities and substitutions. Future policy might well incorporate less reliance on regulation and more on removing barriers to free market factors.
mesh_terms: D002983:Clinical Competence; D004470:Economics, Medical; D013502:General Surgery; D006801:Humans; D007396:Internship and Residency / Q000600:supply & distribution; D011787:Quality of Health Care; D013044:Specialty Boards; D013514:Surgical Procedures, Operative / Q000592:standards*; D014481:United States; D000078329:Workforce