Observations Yankee Doodling

Today's doctor's dilemma

BMJ 2007; 334 doi: https://doi.org/10.1136/bmj.39097.516609.59 (Published 18 January 2007) Cite this as: BMJ 2007;334:126
  1. Douglas Kamerow, former US assistant surgeon general and the BMJ's US editor
  1. dkamerow{at}bmj.com

    The secret to a longer life is nothing we can do anything about in health care

    To George Bernard Shaw, the dilemma doctors faced was choosing between helping patients and helping themselves to lucrative fees. Today's doctor's dilemma is that what we do doesn't make much difference.

    As a young man disillusioned by the politics of the late 1960s, I sought refuge in medicine. The government and politics were making things worse, and I thought that the only hope was helping one patient at a time. I would work as a general practitioner, my patients would feel better, and thus I would make the world a better place. The answer was medical.

    I was wrong. After working in a health centre in an economically deprived neighborhood only a short time, even I figured out that I couldn't “fix” much of what was wrong with my patients. Sure I could prescribe pills and insulin for my diabetic patients, but many of them had neither the means to buy healthy foods nor access to well stocked shops from which to purchase them. I could refer patients to …

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