The new medical-industrial complex

N Engl J Med. 1980 Oct 23;303(17):963-70. doi: 10.1056/NEJM198010233031703.


The most important health-care development of the day is the recent, relatively unheralded rise of a huge new industry that supplies health-care services for profit. Proprietary hospitals and nursing homes, diagnostic laboratories, home-care and emergency-room services, hemodialysis, and a wide variety of other services produced a gross income to this industry last year of about $35 billion to +40 billion. This new "medical-industrial complex" may be more efficient than its nonprofit competition, but it creates the problems of overuse and fragmentation of services, overemphasis on technology, and "cream-skimming," and it may also exercise undue influence on national health policy. In this medical market, physicians must act as discerning purchasing agents for their patients and therefore should have no conflicting financial interests. Closer attention from the public and the profession, and careful study, are necessary to ensure that the "medical-industrial complex" puts the interest of the public before those of its stockholders.

MeSH terms

  • Clinical Laboratory Techniques / economics
  • Economics, Hospital*
  • Ethics, Medical
  • Health Policy
  • Health Services Misuse
  • Home Care Services / economics
  • Hospitals, Proprietary / economics*
  • Industry*
  • Investments
  • Marketing of Health Services*
  • Nursing Homes / economics
  • Physician's Role
  • Renal Dialysis / economics
  • Social Responsibility
  • United States