In Reply I thank Dr Back for his Letter, and I agree with him. My Viewpoint1 was indeed directed mainly to JAMA’s core readership—physicians, but the problems created by a profit-driven health care system go far beyond physicians in both cause and effect. Back’s critique triggers the provocative…

This Viewpoint discusses a recent federal court decision that invaliated the Food and Drug Administration’s (FDA) approval of mifepristone, a drug used to end pregnancies and manage miscarriage when used with misoprostol, and how that decision challenges the legitimacy and independence of the FDA.

This Viewpoint posits suggestions to reform electronic health records (EHRs), including use of unique personal safety identifiers, reduction of administrative and regulatory content from clinical time, inclusion of patient-entered information into the EHR, and reinvention of the clinical note.