Over the past three decades, the American healthcare system has evolved into a complex maze of large corporate conglomerates and bureaucratic processes, placing increased strain on the doctorpatient relationship. Hospital mergers have failed to deliver the promised benefits, and patient-focused care has given way to more impersonal and costly treatments as insurance companies have increasingly influenced doctors’ day-to-day decisions. Costs have risen and the quality of care has declined. Diverse communities are at the most significant risk from these negative trends. This paper will review the transformation of American medicine into the corporate ‘colossus’ we know today and how this transformation adversely impacts diverse communities. It identifies several challenges facing underserved populations and policy reform options to restore the doctor-patient relationship and usher in a more caring future for all. (author introduction)
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