The Corrosion of Medicine
The Corrosion of Medicine
Can the Profession Reclaim its Moral Legacy?
By John Geyman, M.D.
Medicine can no longer deny the extent to which unbridled self-interest has eroded its professionalism. As documented in earlier chapters, these excesses are pervasive throughout the profession, for all to see, involving patient care, education and research as well as academic medical centers and many of the profession’s organizations. The extent of deprofessionalization makes clear that the cause extends well beyond a few “bad apples.” If medicine is to restore its professionalism, the profession must accept responsibility for letting down the public trust, recommit itself to service over self-interest, and build effective mechanisms of self-regulation which can gain the public’s confidence.
Whether medicine will give up its customary defensive mode and respond positively to its moral and professional challenges is an open question. Despite its long struggle to maintain its independence, the profession has lost much of its autonomy as it increasingly serves corporate interests. In a more proactive stance, medicine may recognize a larger role of government as a potential force to support the context within which it can restore its professionalism. Business as usual will not serve the profession or the public well. The profession now has a window of opportunity to expand its vision and lead toward better health care for all Americans. To do so, it must involve itself with rebuilding the capability of public health and with advocacy for real health care reform, which leads us to the last chapters.
http://www.commoncouragepress.com/index.cfm?action=book&bookid=384
Comment:
By Don McCanne, MD
This book was very difficult to read, not because of the complexity of the topic, but rather because of the anguish felt over what has happened to our profession.
Although physicians have been complicit in the processes leading to the corrosion of medicine, their blame lies not with an active role in commercializing health care, but rather with passive acceptance of their role in our current model of health care that is controlled by business and market interests.
When you ask a physician what his/her occupation is, he/she does not say that I am a businessperson in the health care industry. Almost without exception, the response is, “I’m a physician.” That has much greater meaning than merely being engaged in an occupation that takes care of sick people. It is difficult to put into words, but every health care professional knows what I mean.
Although it was painful to be reminded of the compromises being made on behalf of the business of medicine, there is also real hope in the message in this book. You realize that it doesn’t have to be this way. We do not have to passively accept the role of being workers in an industry controlled by market entrepreneurs.
We can become active advocates of reform that places our patients first. If we take health care financing out of the hands of the MBAs and place it under the control of our own universal public financing system, the patients and physicians will be able partner together in achieving the best health care possible within the confines of our finite resources.
Financing reform is only the first step, but it makes the other necessary reforms possible. Not only will we restore our pride in ourselves when we say, “I am a physician,” our patients will once again understand the special meaning of medicine as a profession rather than as a mere business.