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" if the surgeon refuses she can shop around. Problem is, govermental health care has taken price competition out of the equation. You get the same fee if you operate on a 90 with multiple co-morbidites or a healthy 30 year old."

I agree. That is what I mean by "manage". Hire them and fire them if need be.

I don't know why I would let one man assume responsibility for my health when I would not fully trust one man to care for my car.

It takes interaction. It requires education on the part of the patient and questions from the patient. I can understand a doctor who says he "does not know" or once to try something different (because a previous course of treatment did not work) but I cannot stand a doctor who will get defensive when I ask questions.

My doctor has prescribed two medications for me that were not good for diabetics to take. One shot my blood sugars so high and for so long that I had to get another glucose monitor to get the real numbers. The old one just kept saying HI. The other one caused many problems in another diabetic woman. They really don't know what they're prescribing or how it can affect you. I brought in one paper to show him but they don't like to admit they're wrong. I don't have confidence in doctors much anymore.