This conference is just a beginning. Pellegrino had it right when he noted that collectively we are responsible for fidelity to the trust we have solicited from society. First, we put our competition and cooperation in balance, and we quit allowing external forces to dictate that our competitive side will always dominate. Sensible competition among us creates better ideas, which must then be shared among our professions for the benefit of patients. Second, we change our attitudes, including those that direct our relationship with patients, away from the paternalistic notion that compliance with our regimens is the gold standard of care.
Compliance is relevant only if one partner in the relationship is totally in control.
Most of us intellectually support the idea of educating patients to be partners in carrying out their drug regimens, but we also believe that patients must accept our goal of compliance with the regimen we assign. Much research now supports the notion that the best physiological outcomes are not necessarily the most therapeutic for patients. We do not even have a term yet to describe it. Perhaps the closest is a negotiated therapeutic goal between professional and patient, but even that does not adequately describe what the new gold standard should be. Fourth, we consciously use the experience of this conference to build the concept of the ethics of leadership among our disciplines.