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When standards for quality care are being imposed, it can have negative impacts to patients too. If you are an endo, and you have a few elderly patients who have complications, or a significant risk of not feeling a low, it becomes more dangerous to strive for the lower A1c. Does the doctor endanger the patients with an imposed standard, or give the best individual care and risk the rating of his practice.

Most answers to health care reform are not black and white.

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