In 1970, a Fortune magazine cover story warned the nation: "Much of U.S. medical care, particularly the everyday business of preventing and treating routine illnesses, is inferior in quality, wastefully dispensed, and inequitably financed." That year, a Fortune editorial declared: "The time has come for radical change. ... The management of medical care is too important to leave to doctors who are, after all, not managers to begin with."

This was the beginning of the revolution Paul Starr described in his Pulitzer prize-winning 1982 book, The Social Transformation of American Medicine. In his final chapter, "The Coming of the Corporation," Starr expressed his concern that "those who talked about 'health care planning' in the 1970s now talk about 'health care marketing.' Everywhere one sees the growth of a kind of marketing mentality in health care. And, indeed, business school graduates are displacing graduates of public health schools, hospital administrators and even doctors in the top echelons of medical care organizations.