Second Opinion: ‘Professionalism’ — No Substitute for Medical Ethics
By Jerome Arnett Jr., MD “Paging Dr. Hippocrates” (October, 2007) is an excellent and timely article that explores physician dissatisfaction, an important problem for today’s physicians.
But the article advocates exactly the wrong prescription in suggesting that physicians embrace the concept of “medical professionalism” as a solution to this discontent. Medical professionalism is described as a “large concept” whose principal tenet is “selfless concern for patient care.” In the article, Christine Cassel, MD, president and CEO of the American Board of Internal Medicine (ABIM) and the ABIM Foundation, noted that physicians “don’t feel like they are doing the right thing.” They have a perception that they are failing their patients. Her solution is to “create systems” so that doctors can “spend more time on the tasks that the doctor ought to be doing …”
According to the article, physicians may become cynical because they are not paid fairly for their work, or because they have lost control over medical decision-making, or because they are corrupted by conflicts of interest inherent in systems such as Medicare, Medicaid, and private insurance. But, in fact, it is our medical ethics — not medical professionalism — that provides us with a code of values so we can choose right from wrong in order to successfully deal with conflicts of interest.
Medical professionalism is not a code of ethics — and the distinction is vital. Physicians are ethically required to reject any scheme, however well-meaning, that comes between them and their patients. The concept of medical professionalism, as outlined by ABIM and described in your article, is such a scheme. Continued...
