After visiting a Colorado dude ranch recently, I couldn't help acknowledging the several business lessons I gained from my equestrian experience. And it was a very fun metaphor to work with!

We all know, and will begrudgingly admit, that taxes have to exist to pay for key services that only some arm of government can provide. Police? Check. Fire? Check. Roads? Check. Military? Check. And so on, ad infinitum. But it is the ad infinitum that encompasses most of the conflicts. Where does the spending, and the taxing, or the indebtedness stop, and at what cost point?

As the regulations that will define the shape of our reformed healthcare system are fleshed out, evidence continues to emerge that our legislators may have burdened us with a raft of new rules that could do lasting damage to physicians and their patients. Far from promoting greater access and improved care, these changes may instead end up denying patients' freedom of choice, degrading physicians' clinical decision-making authority, and disrupting the trusted physician-patient relationship.