The Physician’s Call to Action

In his article, The Medical Profession as a Moral Community, Edmund Pellegrino adds a slight twist to the health as a commodity vs. right debate by placing responsibility in the hands of the medical community. Previously in class we have discussed the role of the public and private sector in health care distribution; however, we have not yet delved into the moral weight it holds over physicians. Pellegrino argues that the medical community is likewise a moral community and as such must unite on ethical issues and serve as a voice for the patient, putting the primary responsibility of caring for the sick above all self-interests. I agree with Pellegrino’s argument and believe that in order to achieve better health among Americans, collective action by medical professionals is needed.

Physicians comprise a moral community: they have made a promise among themselves and society to do no harm, exist within a body that stands on its own regardless of specific membership, and are part of an entity that holds great power (Pellegrino). The oath of a physician promises beneficence and non-maleficence. This is a tall order. No physician alone is capable of protecting all of society, this “spectrum of obligations [belongs] to the whole moral community” (Pellegrino). Doctors have power over vulnerable patients, make decisions that have life-altering consequences, hold knowledge that is available to a privileged few, and are often the final say in a patient’s health (Pellegrino). Every decision made by a doctor is reflected upon the medical community, which is why, aside from the Hippocratic Oath, there are currently in place several regulations and standards upheld by physicians.

Concepts of health and illness have taken a dramatic shift over the last several decades and with them the responsibilities if the modern doctor. Not only is he/she to protect the ill, they are also to do their best to prevent illness and help to maintain health and wellness. Why is it then that much of patients’ money goes to administrative fees? Unnecessary tests? Most importantly, why are doctors refusing to see patients based on insurance type? Though doctors are professionals and provide a valuable service, net profit should not be at the front of their minds when vetting a patient. Instead of thinking about how much money they can make off of an individual, doctors should be primarily concerned with what they can do to help them.PHILS 316 Blog Photo

The American Medical Association (AMA) has often taken collective action on important issues. For years they had a huge hand in preventing universal health care reform, when really, it should have been the other way around. Instead of allowing self-interests, namely profits, influence their response to potential reform, physicians should have rallied along the idea of providing more care to individuals who can’t afford it. Patients do not exist under a large, resource-wealthy interest organization like doctors do within the AMA. Thus, regardless of socioeconomic status, patients are not as effective in making their opinions heard and enacted at the policy level. Only the medical community is capable of this.

Although I believe the medical community is responsible for raising expectations  in access to health care, I also understand that they are people that work hard with bills and material desires just like the rest of us. Medical school is incredibly timely and expensive. If the U.S. government were to adopt a system that paid for medical school, I think it would be more reasonable to force all practices to accept Medicare and Medicaid insurance schemes.

Individually, physicians may not have a lot of clout and influence over the government and areas of the private sector; however, if they use their collective power, medical doctors have a chance to truly fulfill the promises they made to protect the people.

Pellegrino, E. D. “The Medical Profession as a Moral Community.” Bulletin of the New York Academy of Medicine 66.3 (1990): 221-32. NCBI. Web. 20 Apr. 2014.

5 thoughts on “The Physician’s Call to Action

  1. I completely agree with many aspects of your argument. Physician’s main focus does not seem to be on providing help to the patients in the modern day and age. The fact that you referenced health insurance as a barrier to physicians helping patients is an accurate example of flawed values. When I go to the Doctor the first thing I’m asked for is my insurance type, which helps demonstrate that economic self-interest is overpowering the health of individuals.

    Also, how come there are lines out the door at emergency rooms? There have even been cases of deaths while waiting for assistance, which is completely unacceptable. Since emergency rooms do not care what type of insurance you have or if you even have it, there is obviously an issue with the way in which the service is being run; economic issue or not. Lastly, your comment regarding the U.S government paying for medical school is understandable but unrealistic. Even though that would save individuals large sums of money, I feel as if it would cause a deficit in the future, therefore creating more costs than benefits.

  2. I quite enjoyed readin your post on the physician’s role in health care reform. I feel as though for the majority of physicians, the main reason why they became doctors in the first place was because they had an interest in helping others. The fact that medical care has materialized into a business has certainly created a conflict of interest for many physicians. As you articulated, medical school is extremely time-consuming and expensive. Physicians end up graduating with huge amounts of debt and subsequently expect to be paid generously to help pay off this debt. This curtainly has negative implications for the system when a physician is partialy compensated on a fee for service basis. I do not believe it is appropriate for physicians to be paid on a fee for service basis because of the possibility that a physician could abuse the system.

  3. One thing that really struck me was your suggestion that the United States government pay for medical school for aspiring doctors. I found this ironic as in one of my other classes, we were discussing how when students are loaned money to go to medical school, the government actually makes a significant profit off of each individual. To turn that around on end would be an extremely drastic change and while it may sound nice on paper and in theory, I feel it would not be realistic, as it would completely change the perception of practitioners of medicine.
    I really liked how Cara brought up the fact that the first you’re asked for when entering a doctors office is your insurance. This definitely exemplifies the new money oriented view of medicine, while I agree the most go into medicine hoping to help others.

  4. Although I agree with your argument that doctors are held to a moral standard in which they should focus on the needs of the patient instead of their own, this is not exactly ideal. Indeed, the path to becoming a physician is an expensive one, but physicians don’t only have to worry about how they will be paid. They must also be able to make enough money to continue to run the hospital or clinic within which they work. Unfortunately, the cost is going up and physicians have to somehow keep their clinic running. The best way to do this is to schedule more patients, but this will decrease the amount of time they spend with the patient. The resources are becoming more scarce and more expensive (which makes sense according to the law of supply and demand). Moreover, being a physician is very stressful, so a little incentive goes a long way in order to keep them interested in serving their patients. It appears that this problem will not be dissipating anytime soon; however, this system needs some serious re-working.

  5. I completely agree with Geovonni, as financial capacity is an important note to consider in discussing this (I beleive I bring it up in another related post). What he brings up that triggered a new thought was the idea of supply and demand. I consider now, at this point, that the only way (affordable way) to fix the health care problem in our country is to create more hierarchies of medical workers. We have doctors and nurses, and later the boom of physicians’ assistants, and perhaps we need even one more category in between this and nurses. This is so that there is also a balance for people to have such jobs, and there are educated people available to help the health of others, as they may understand very little about their bodies. Physicians’ Assistants do not need to go to medical school but have a similar undergrad career and experience. This is a good option for those who want to help others medically but do not want the mountain of debt, and the population benefits from having someone more scientifically knowledgeable than their mothers diagnosing them! This job is providing a lot more healthcare workers into the system, so supply and demand is not too skewed!

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