Ethical aspects of the physician surplus: implications for family practice.

Higher costs, increasing technology, and more physicians are the three predominant influences facing medicine today. These three forces in turn present three groups of ethical issues for physicians: competition and changed fiscal incentives, effects of organized practice on autonomy and confidentiality, and the problems of the interface between primary and consultant physicians. Family physicians must learn to adapt their practices in ethical ways to the rapid changes that are occurring. Thoughtful insight is essential to the process.