In this study, Dr. Ashraf A. Hilmy, with a surgeon's objective, no-nonsense precision and an unabashed lack of political correctness, dissects the current state of health-care delivery in America. In practice since 1979, he is board certified in surgery, anesthesiology, critical-care medicine, and health-care administration. He received an MBA from the University of Texas, Pan Am with an emphasis on health-care administration. He has served as both chief of surgery and staff at several institutions and has practiced in every scale of facility-solo, partnership, and group practice.