That was before the monetarization of the health care system and before there was much opportunity to amass wealth by investing in health care. With the coming of investor-owned health care, the social service ethos of U.S. medical care has given way to the entrepreneurial imperative. Most private hospitals, whether investor-owned or not, now behave like profit-seeking and market-share seeking businesses, and increasingly are managed by high-paid corporate-style executives whose attention is fixed on the bottom line. Even many teaching hospitals and academic health centers now are engaged in entrepreneurial activities hardly compatible with their primary professional commitments. Doctors have also increasingly succumbed to business incentives. Gradually over the past few decades, health care has indeed come to resemble a vast profit-oriented industry.