RE “Medicare payment changes draw fire” (Page A1, Nov. 26): The outcry from specialists over changes to Medicare payments is the inevitable result of decades in which physicians failed to acknowledge the crisis in rising medical care costs and participate in solving it.

Physicians control medical care costs by ordering evaluation, treatment, and surgical and other procedures for their patients. They also play a key role in managing expensive hospital stays, either as primary care doctors, hospitalists, or specialists.