Medicine: the prosperity of virtue
The Lancet
Many doctors in Britain today feel under siege. They are told that the services they offer do not meet the standards demanded by the public. They are told that they are not delivering for patients. They are told that other groups can do what they do as well as they can or perhaps even better (prescribing, for example). They are told that they must embrace new providers in healthcare because that is the only way to break the restrictive practices they have been imposing for decades.1 They are told that a new raft of medical regulation is needed to prevent the crimes of Harold Shipman and the negligence of others from happening again.
The attitude of the state towards doctors has never been more critical. It has led to panic at some medical institutions with occasionally disastrous consequences.2,3 This dimming of the profession's flame will be welcomed by critics of professional power. But the endemic demoralisation of doctors today is creating a cold front of danger that threatens the public's health.
Professionalism is medicine's most precious commodity. Professionalism is not some old-fashioned luxury enjoyed by a privileged elite. It is central to the improvement of health. Yet professionalism is currently jeopardised by a political culture that is hostile to any source of power that is seen as competitive with government. Doctors have been largely outmanoeuvred by a far more adaptable and intelligently strategic political class. For too long they have clung to an idea of professionalism that has included ancient concepts such as autonomy, mastery, and bounded knowledge. These elements of an anachronistic professionalism are now obsolete. Doctors should see the demise of these outmoded ideas as an opportunity for redefining their purpose in a radically different era./.../
Many doctors in Britain today feel under siege. They are told that the services they offer do not meet the standards demanded by the public. They are told that they are not delivering for patients. They are told that other groups can do what they do as well as they can or perhaps even better (prescribing, for example). They are told that they must embrace new providers in healthcare because that is the only way to break the restrictive practices they have been imposing for decades.1 They are told that a new raft of medical regulation is needed to prevent the crimes of Harold Shipman and the negligence of others from happening again.
The attitude of the state towards doctors has never been more critical. It has led to panic at some medical institutions with occasionally disastrous consequences.2,3 This dimming of the profession's flame will be welcomed by critics of professional power. But the endemic demoralisation of doctors today is creating a cold front of danger that threatens the public's health.
Professionalism is medicine's most precious commodity. Professionalism is not some old-fashioned luxury enjoyed by a privileged elite. It is central to the improvement of health. Yet professionalism is currently jeopardised by a political culture that is hostile to any source of power that is seen as competitive with government. Doctors have been largely outmanoeuvred by a far more adaptable and intelligently strategic political class. For too long they have clung to an idea of professionalism that has included ancient concepts such as autonomy, mastery, and bounded knowledge. These elements of an anachronistic professionalism are now obsolete. Doctors should see the demise of these outmoded ideas as an opportunity for redefining their purpose in a radically different era./.../
posted by Aloyzio Achutti | 10:07 AM
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