“The good have no need of an advocate.” Such is a quote from the Athenian statesman Phocion (402-318 B.C.). Perhaps in Athens, in the 4th century B.C., it was easy for a politician and strategist to come to such a conclusion. There was, after all, open discourse in this early democracy. On the other hand, Phocion was sentenced to death by his fellow Athenians. He was at one time considered good. He defended himself against accusations of treachery. Nevertheless, he was convicted; his punishment was to drink hemlock. Perhaps an advocate would not have been such a bad thing after all.

It has been 25 years since the completion of my residency in anesthesiology. Through many different modes of practice (solo and small-group private practice to large-group academic practice), the one constant has been the changing field of play. I’m referring not to the fundamentals of the science of...

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