In Reply:-The concerns raised by Dr. Davila are important and thought-provoking. He challenges us to contemplate the balance of economic issues with ethical and patient care concerns. Only knowledgeable and honest debate will allow us to evolve a strategy that can best advocate our profession while protecting our patients. May the debate continue!

Barry A. Shapiro, M.D.

James E. Eckenhoff Professor and Chair; Department of Anesthesiology; Northwestern University Medical School; Chicago, Illinois 60611

(Accepted for publication July 29, 1997.)