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Are we choosing a career in primary care with professionalism in mind, willing to serve as someone's personal physician and practice accessible (24/7), comprehensive, continuous (inpt and oupt), personalized care or are we choosing to be a 9-5 corporatized doctor who seeks to minimize work time and responsibilities in favor of maximizing personal time. If the answer is the latter, then I would argue that it fails the definition of professionalism and makes such persons very vulnerable to the external forces noted in the book. If it is the latter, then such counterproductive external forces will be countered until corrected, because they impair patient care. We've done this with payment reform for primary care, which is now moving nationally from volume-based payment to comprehensive payment for comprehensive care (e.g., Medicare's CPC Plus program of payment reform for primary care). The choice is ours.