Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

The professional status of physicians is at risk

Richard A. Foullon, MD
Physician
July 12, 2011
Share
Tweet
Share

According to Wikipedia, up to the beginning of the 19th century there had been only 3 occupations that were considered to be professions, Divinity, Medicine and Law.

A profession is considered a trade or occupation that transforms itself through “the development of formal qualifications based upon education, apprenticeship, and examinations, the emergence of regulatory bodies with powers to admit, discipline members, and enforce adherence to an ethical code of practice.”

Professionals are autonomous, with the “freedom to exercise their independent, professional judgment,” and have “a high degree of control over their own affairs.”  All professions have power, used to control the conduct of its own members, as well as “exercise a dominating influence over its entire field which means that professions can act monopolist, rebuffing competition from ancillary trades and occupations.” A profession is characterized by the power and high prestige it has in society as a whole. It is the power, prestige and value that society confers upon a profession that more clearly defines it.

Physicians have historically been considered the cornerstone of medicine, one of the original and oldest professions. As a result, physicians have for many years now enjoyed a high social status, regard and esteem conferred upon them by society. This high esteem arose primarily from societies’ view and appreciation of the “higher social function of their work, which is regarded as vital to society as a whole” and thus of being special and holding valuable.

I do not believe that the majority of physicians today find themselves meeting many of Wikipedia’s defining characteristics of a profession. Neither as individual physicians, nor as a profession as a whole, do we find ourselves with any significant degree of autonomy, control or power over our own affairs.

Have we done as much as we could have to enforce our ethical code? Do we find ourselves dominating and truly in a position to protect our area of expertise? Have we done and are we doing all we can to ‘rebuff’ the competition? Over time we have gradually accepted being told more and more what to do and how to do it. I believe that to whatever degree we once may have met the defining characteristics of a profession, it was granted to us based solely upon our having survived the education, examinations and apprenticeship(s) we went through. At some point we probably had power enough to protect our area(s) of expertise, but I’m not sure we ever really made the most of it, or even realized we had it.

Over the last several years I believe that as physicians we have put up relatively little resistance to being told what our professional judgment will be, at least if we want to get paid, now referred to as reimbursed. This would not necessarily be all bad, if not for the fact that so much of what we’re being told is based upon cost to the payor and not true quality for the patient. Our government who started things off with entitlements has and is finding it necessary to weigh in even more heavily in order to keep our economy from taking a double dip, or prolonging its slow recovery.

Some hospital systems have formed foundation models, or other types of legal entities needed in their particular state, in order to buy, control and employ groups of physicians. Insurance companies are also getting into the act by buying both hospitals and physician groups. I wonder whose best interest is being considered here. Other hospitals, which are fortunate enough to monopolize their service area, are charging just about however much they want per overnight stay, and insurers have to pay, leaving that much less for physicians and the rest of the healthcare systems’ participants.

Upon entering the profession, I believe that many physicians did not realize that along with the privileges granted to them came the responsibility to guard and protect those privileges, the most important of which was the responsibility of making sure that things were always done in the best interest of the patient. Changes to the characteristics of our profession simply snuck up on most physicians. There has been a certain amount of conscious neglect on our part, most probably from being progressively overwhelmed by busy work, as well as not really knowing what to do about it. How best to protect our area(s) of expertise and/or rebuff the forces working to take away and assume our control, were not part of our education or training.

There has been a fair amount of talk for a while now about the needs for and benefits gained by all parties involved, (e.g. patients, physicians and hospitals) by joining forces and establishing better overall business models, like ACOs. Whether or not you agree with this concept is not as important as that you realize the following. If we care enough about the privileges we earned and the responsibilities that go along with them, it is well past the time that physicians unite, reach common ground, stand up for all that is needed to maintain our status as a profession, thereby allowing us to fight for and protect all that is in a patient’s best interest.

If we don’t, then we should simply expect our continuing transformation back from a profession to a trade or occupation, under the ever increasing control of others.

Richard A. Foullon is a family physician.

 

ADVERTISEMENT

Submit a guest post and be heard on social media’s leading physician voice.

Prev

A private sector solution for wider, more affordable health coverage

July 12, 2011 Kevin 20
…
Next

Let go of guilt while trying to get your baby to sleep

July 12, 2011 Kevin 9
…

Tagged as: Primary Care, Specialist

Post navigation

< Previous Post
A private sector solution for wider, more affordable health coverage
Next Post >
Let go of guilt while trying to get your baby to sleep

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

More by Richard A. Foullon, MD

  • a desk with keyboard and ipad with the kevinmd logo

    Clinical competence, and whether a doctor is good, or not

    Richard A. Foullon, MD
  • a desk with keyboard and ipad with the kevinmd logo

    Reasons behind the image mutation of physicians

    Richard A. Foullon, MD
  • a desk with keyboard and ipad with the kevinmd logo

    A moral obligation to help patients decipher online health information

    Richard A. Foullon, MD

More in Physician

  • Why the physician shortage may be our last line of defense

    Yuri Aronov, MD
  • 5 years later: Doctors reveal the untold truths of COVID-19

    Arthur Lazarus, MD, MBA
  • The hidden cost of health care: burnout, disillusionment, and systemic betrayal

    Nivedita U. Jerath, MD
  • Why this doctor hid her story for a decade

    Diane W. Shannon, MD, MPH
  • When errors of nature are treated as medical negligence

    Howard Smith, MD
  • The hidden chains holding doctors back

    Neil Baum, MD
  • Most Popular

  • Past Week

    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
    • Addressing the physician shortage: How AI can help, not replace

      Amelia Mercado | Tech
    • Why medical students are trading empathy for publications

      Vijay Rajput, MD | Education
    • Why does rifaximin cost 95 percent more in the U.S. than in Asia?

      Jai Kumar, MD, Brian Nohomovich, DO, PhD and Leonid Shamban, DO | Meds
    • Why physicians deserve more than an oxygen mask

      Jessie Mahoney, MD | Physician
    • Avarie’s story: Confronting the deadly gaps in food allergy education and emergency response [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • How dismantling DEI endangers the future of medical care

      Shashank Madhu and Christian Tallo | Education
    • How scales of justice saved a doctor-patient relationship

      Neil Baum, MD | Physician
    • A faster path to becoming a doctor is possible—here’s how

      Ankit Jain | Education
    • Make cognitive testing as routine as a blood pressure check

      Joshua Baker and James Jackson, PsyD | Conditions
    • The broken health care system doesn’t have to break you

      Jessie Mahoney, MD | Physician
  • Recent Posts

    • Avarie’s story: Confronting the deadly gaps in food allergy education and emergency response [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why the physician shortage may be our last line of defense

      Yuri Aronov, MD | Physician
    • 5 years later: Doctors reveal the untold truths of COVID-19

      Arthur Lazarus, MD, MBA | Physician
    • The hidden cost of health care: burnout, disillusionment, and systemic betrayal

      Nivedita U. Jerath, MD | Physician
    • What one diagnosis can change: the movement to make dining safer

      Lianne Mandelbaum, PT | Conditions
    • Why this doctor hid her story for a decade

      Diane W. Shannon, MD, MPH | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 14 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
    • Addressing the physician shortage: How AI can help, not replace

      Amelia Mercado | Tech
    • Why medical students are trading empathy for publications

      Vijay Rajput, MD | Education
    • Why does rifaximin cost 95 percent more in the U.S. than in Asia?

      Jai Kumar, MD, Brian Nohomovich, DO, PhD and Leonid Shamban, DO | Meds
    • Why physicians deserve more than an oxygen mask

      Jessie Mahoney, MD | Physician
    • Avarie’s story: Confronting the deadly gaps in food allergy education and emergency response [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • How dismantling DEI endangers the future of medical care

      Shashank Madhu and Christian Tallo | Education
    • How scales of justice saved a doctor-patient relationship

      Neil Baum, MD | Physician
    • A faster path to becoming a doctor is possible—here’s how

      Ankit Jain | Education
    • Make cognitive testing as routine as a blood pressure check

      Joshua Baker and James Jackson, PsyD | Conditions
    • The broken health care system doesn’t have to break you

      Jessie Mahoney, MD | Physician
  • Recent Posts

    • Avarie’s story: Confronting the deadly gaps in food allergy education and emergency response [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why the physician shortage may be our last line of defense

      Yuri Aronov, MD | Physician
    • 5 years later: Doctors reveal the untold truths of COVID-19

      Arthur Lazarus, MD, MBA | Physician
    • The hidden cost of health care: burnout, disillusionment, and systemic betrayal

      Nivedita U. Jerath, MD | Physician
    • What one diagnosis can change: the movement to make dining safer

      Lianne Mandelbaum, PT | Conditions
    • Why this doctor hid her story for a decade

      Diane W. Shannon, MD, MPH | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

The professional status of physicians is at risk
14 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...