Dr. Salah Salman's critique of American medicine is wide-ranging, from the millions who lack health insurance to the dangerous failure of doctors to police each other. But one of his central tenets is that medicine should not be seen as a business, and that money corrupts its practice. The following lightly edited excerpt, posted with his permission, focuses on an area of his expertise as an ear, nose and throat specialist: Chronic sinusitis, and a form of surgery to treat it that has exploded despite questionable benefits.