There is possibly the shadow of the barefoot doctors in opposition to the highly specialized, urban doctors when there is the mention of hospital-based staffs.

But then medicine began to approach the second watershed. Every year medical science reported a new breakthrough. Practitioners of new specialties rehabilitated some individuals suffering from rare diseases. The practice of medicine became centered on the performance of hospital-based staffs. Trust in miracle cures obliterated good sense and traditional wisdom on healing and health care. The irresponsible use of drugs spread from doctors to the general public. The second watershed was approached when the marginal utility of further professionalization declined, at least insofar as it can be expressed in terms of the physical well-being of the largest number of people. The second watershed was superseded when the marginal disutility increased as further monopoly by the medical establishment became an indicator of more suffering for larger numbers of people. After the passage of this second watershed, medicine still claimed continued progress, as measured by the new landmarks doctors set for themselves and then reached: both predictable discoveries and costs. For instance, a few patients survived longer with transplants of various organs. On the other hand, the total social cost exacted by medicine ceased to be measurable in conventional terms. Society can have no quantitative standards by which to add up the negative value of illusion, social control, prolonged suffering, loneliness, genetic deterioration, and frustration produced by medical treatment.