Abstract
Maintaining a high quality of medical care among physicians who characteristically depend upon patient choice for their success seems to be particularly difficult. One way of achieving high quality is said to be group practice. Study of patients of a medical group which gives care of high quality indicated that they are, by and large, satisfied. However, analysis of cases in which care was sought elsewhere indicated that the very attributes responsible for high professional quality were those making for a certain rigidity in response to the patient's demands. Inasmuch as the growth of group practice is likely to absorb what are now the safety-valve practices presently used by dissatisfied patients, attention must be paid to ways of restraining the development of a new pro fessional syndicalism which merely excludes and rejects patients with nowhere else to go.

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