By Paul Jay Fink, M.D. professor of psychiatry at Temple University School of Medicine and senior consultant for Charter Fairmount Behavioral Health System. React to this article in the Discussion Forum. Everyone seems convinced that regard for the professional of medicine has been eroded both from without and within. The constant pounding by the media about the bad things that have been discovered about hospitals and doctors has had a corrosive effect. The insistence by the community that we are rude, rich, selfish and uncaring has also taken its toll.
Doctors are under attack.
Their income has been continually eroded by managed care companies, intense competition, the purchase of practices, as well as the government's attempts to control health care costs. Their role has become more confused by the growth of a profusion of other professionals and paraprofessionals, all of whom are looking for a piece of the pie. Their confidence has been eroded by the commodification of health care in which the responsibility for the patient's care has been divided among a number of caretakers, case managers, and family members who believe, rightly or wrongly, that their input has the same value as the clinical opinion of the physician. The effect of all this on medical ethics and medical education has been devastating. Practicing medicine from the position of covering one's back is now a way of life.