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“Be not afraid of greatness: some men are born great, some achieve greatness, and some have greatness thrust upon them.”

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William Shakespeare, Twelve Night, Act II, Scene 5

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Power is an unusual commodity for many reasons, not the least of which is that first one must decide what it is and what it means. The ability to influence events and outcomes in one's favor is one definition of power. Physicians have held a common misconception that if they do the right thing consistently for the patient, ignoring everything else, their good works will speak for themselves, and they will not have to worry about the outside world. This is understandable, naïve, and wrong. As Henry Mencken correctly noted

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“For every complex problem, there is a simple solution. …And it is wrong.”

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We live and work in a political environment; everything we do is political to some extent. When patients paid their own bills, they reached in their pockets and they took out their wallets. Doctors had to ask them for the money and they had to give it to them. Patients had the ultimate control in this system because they would ask questions, such as, “Doctor, do I really need that? Doctor, do I really have to have this done?” The doctor had to sit there and think, “You know I bet there is a less expensive way to do this for this person or family.”

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Since the end of World War II, however, the money for healthcare has been concentrated into larger and larger entities. At least half the hospital bills in the United States today are paid by the federal government. As a result, doctors are no longer able to negotiate with each patient or each small pay or for fees. It is done en masse. Whenever money is concentrated, money and power run together, but they are not the same thing. Lots of people have money but little power. Some people have little money but some power. Some people have no money, but immense power.

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People who think that they have power, probably do. Those who don't think that they have it, don't. Real power, the only power that actually exists in the world, is getting people committed to your ideas. How is that done?

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Rule number 1 is cautionary:

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“Power corrupts. Absolute power corrupts absolutely.”

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Lord Acton

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Lord Acton is right, but emergency caregivers need not worry about it because they don't have absolute power, despite the fact that they do have absolute liability.

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Rule number 2 provides an important lesson that follows this rule: When you use power for yourself, you lose it.

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When a person uses power for others or for the cause, that person gains ...

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