"We tainted the environment in which physicians collect information," he said.
They work predominantly in settings that are dominated by physicians and in which physicians represent the upper and controlling class.
So was a customer-referral program in which physicians could receive hundreds of dollars in free products for steering other doctors to Neurometrix.
Although virtually unknown to consumers, the information has long been considered the most potent weapon in pharmaceutical sales — computerized dossiers showing which physicians are prescribing what drugs.
Another big maker, Medtronic, has turned three tractor-trailers into traveling mock operating rooms in which physicians can learn how to use cardiac resynchronization devices.
Also this year, Kaptchuk published on the ethics of placebos, which physicians once prescribed routinely for diseases that had no remedy.
As for the "paradigm shift" he had so enthusiastically envisioned, that, too, has become a casualty, at least in the short term, of the realities of health-care economics and the intensity with which physicians guard their sources of revenue.
In his first speech of the year Jeremy Hunt will call for a culture change in NHS hospitals which physicians have told him now deliver patient care in "a series of brief encounters".
But such price-cutting blurs the line between the tactics of commerce and the practice of medicine, in which physicians have traditionally encouraged treatments based on a patient's condition or concerns, not on the doctor's bottom line.
"A preremoval hearing would significantly reduce the speed with which the patient can be evaluated and then receive the care and treatment which physicians have reason to believe that the patient may need," the court ruled.
Evolent has developed a program called Transition Care, for instance, in which physicians, nurses, and health coaches build and implement care plans for patients who have been discharged from the hospital.
