When a big hospital chain buys an independent doctor's office, we often hear the move will "enhance care," "integrate care" or "improve health-care efficiency." Spare us the euphemisms. Patients are the losers in these deals. We pay higher costs. We get fewer choices because doctors are pressured to refer patients only to providers who also work for the hospital. And, because these acquisitions are so common today, an independent doctor's office is becoming as quaint as the house call.