Competition and technology's consort

0 ver the years, the medical profession has enjoyed a considerable amount of trust from the public. This trust is in part a result of the humanitarian tradition embodied in the practice of medicine, and in part due to medicine’s status as a true profession. As professionals, we physicians are entrusted to act in the patient’s best interest, and, as a profession, we are expected to educate and monitor ourselves to assure that we behave according to generally accepted standards, Supreme Court Justice Louis Brandeis has noted that true professionals possess four distinguishing characteristics, First, they are the keepers, transmitters, and advancers of knowledge gained at least in part through experience. They are governed by a guiding code of ethics that includes service to others. They set and enforce their own standards. Finally, performance is valued above reward [2]. Medicine is arguably the profession that enjoys the most respect and is most expected to behave this way. The humanitarian tradition was especially critical to the doctor’s role when the doctor had little of therapeutic value to offer the patient with serious disease. During the 20th century, medicine changed from simply a caring activity to a curing activity blessed with remarkable therapies and technologies. As technology achieved ascendency, there was considerable concern, especially among academicians, that technology could overwhelm humanitarianism and other features of medical professionalism. The late Walsh McDermott, with David Rogers, made an eloquent appeal [3] in support of the humanitarian aspects of the medical profession in an essay developed around the theme of “samaritanism.” According to McDermott samaritanism, the human support function, was in danger of being overwhelmed by technology. Technology and, in particular, over-reliance on technology, can interfere with the very human bonds between doctor and patient that are so critical to caring for patients. He and others expressed concern that in a world of increasing reliance on medical technology, “There is grave danger that medicine will continue to lose ground as an important healing social force extending well beyond simply its technology” [3]. One solution was to promote one of medicine’s most desirable traits, samaritanism. After all, samaritanism and medical science share the same goal-tempering the harshness of illness and disease. Furthermore, McDermott, a self-proclaimed Tolstoian, agreed with Tolstoy that “the germ of every human quality exists in us” [3] even though we might not consistently be imbued with love of our fellow man or a deep desire to help our fellow man. Samaritanism could be technology’s consort-the humanitarian force to accompany medical technology. Samaritanism could lessen the distance that technology can create between doctors and patients [4]. It can counteract the mechanization of medical care. Perhaps most importantly, samaritanism, as the human support function, has healing and consoling effects of its own-effects that the medical profession can ill afford to lose. I believe that most physicians share the ideals expressed by McDermott. The desire to promote samaritanism and other humanitarian values was a force that motivated many to choose medical careers. In addition, the goals of progressive medical education are to harness technology as effectively as possible through research and teaching and to promote samaritanism among trainees and practitioners. Although advancing technology clearly can and has caused problems for the profession, both the profession and the public are attempting to address the problem. In retrospect, advancing technology has not overwhelmed the healing, human support f0rGS.S of medicine (samaritanism). Perhaps we have followed