"We propose that devotion to the best medical interests of each individual patient be replaced with an ethic of devotion to the best medical interests of the group for which the physician is personally responsible. Physicians who compromise optimal treatment for one patient in order to do more good for other patients can still profess strong devotion to patient welfare. The shift from individual health to group health is consistent with the focus of many HMOs on the health of the populations they serve and with the basis on which HMOs and providers are increasingly being judged for quality of care."