I agree with Bobby J. Newbell, MD, in that William J. Baumol certainly was correct in his time [Opinion, November/December 2007]. Sadly, Baumol's disease has now become more virulent. To further extend Dr. Newbell's Mozart quartet analogy, not only must today's music be flawless, but the performers also must now document all the bowing, fingering and pizzicato. They must both perform and prove precisely what they played. This takes time and effort, which makes the performers less efficient.

Electronic health records have enabled us to play similar music, but I suspect that our health care encounters are sounding ever more hollow and canned. Certainly we know the difference, and I suspect that both Mr. Baumol and our audience know the difference as well.