To maintain ethical medical practices, we must not underplay the vocational aspect of medicineBMJ 2020; 368 doi: https://doi.org/10.1136/bmj.m1266 (Published 31 March 2020) Cite this as: BMJ 2020;368:m1266
“The good physician treats the disease; the great physician treats the patient who has the disease.” William Osler
Most professions probably contain a tension between the vocational ideal and the everyday nitty gritty of the work.1 But for doctors, the vocational aspect seems particularly important—people see doctors at their most vulnerable, and doctors carry the ethical responsibility for providing them with the most effective care available in a compassionate manner to help them heal.
The danger of conceptually reducing medical practice to a purely business function (“just a job”) is shown by the burnout—more aptly termed “moral injury”— doctors are experiencing in the US. When care is rationed according to the profit motive rather than principled population health concerns, individual doctors must routinely wage ethically mandated campaigns in support of their patients’ needs against dehumanised corporate bureaucracies. Aside from the emotional weariness induced by this predicament, the time needed to meet corporate demands for data routinely forces doctors to compromise either the quality of care they provide to a patient or the time they can devote to their personal lives.
To my knowledge, bankers and real estate agents inspire no lofty quotes by the likes of Sir William Osler. To maintain a human centred medical environment, we must not underplay the vocational aspect of medicine.
Competing interests: None declared.