In hindsight, there have been unintended systemic consequences stemming from the traditional roles physicians have assumed and the structures within which they have been permitted to organize themselves. It is critical that the national discussion take account of this because we must reconcile ourselves to the current reality in which all other allied healthcare professionals are practising at "the top of their licence." Furthermore, the pace of technological change, especially the deciphering of the genome and the digitalization of virtually everything, has engendered a revolution characterized by the democratization of knowledge and technology, so that the point of care will be wherever the patient is. Dysfunctional reimbursement schemes and a lack of accountability are merely symptoms of a system that must change.

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