Saturday, January 01, 2005
The End of Medicine as a Profession?
When in England I read The Daily Telegraph, a politically conservative paper and the largest by circulation in the country.
During my most recent visit, a major news item in the December 10, 2004 issue had to do with a report from Dame Janet Smith, a judge charged with investigating the activities of one Harold Shipman, a physician who is believed to have killed at least 215 patients with lethal injections of morphine.
That investigation led her to examine at some length the performance of the General Medical Council, the government body referred to as Britain’s medical watchdog. It seems that the GMC is controlled by physicians, some of whom are directly elected to membership by the profession itself.
While not holding it responsible for the crimes of Dr. Shipman (who hanged himself in his jail cell last January), Dame Smith said “Having examined the evidence, I have been driven to the conclusion that the GMC has not, in the past, succeeded in its primary purpose of protecting patients. Instead, it has, to a very significant degree, acted in the interests of doctors.”
Her report then went on to recommend a number of measures, the result of which would be to dilute the control that the medical profession has over the discipline of physicians and, ultimately, to remove that control altogether if the performance of the GMC does not improve.
A profession is understood to involve specialized knowledge and skills not possessed or comprehended by the laity. It follows that oversight of the performance of those within the profession should be the responsibility of the profession itself since no one outside the profession would be competent to do it.
Dame Smith threatens to take responsibility for the oversight of medical practice away from physicians. To a considerable extent, that has already happened in the U.S.
Does that mean that medicine no longer qualifies as a profession?
When in England I read The Daily Telegraph, a politically conservative paper and the largest by circulation in the country.
During my most recent visit, a major news item in the December 10, 2004 issue had to do with a report from Dame Janet Smith, a judge charged with investigating the activities of one Harold Shipman, a physician who is believed to have killed at least 215 patients with lethal injections of morphine.
That investigation led her to examine at some length the performance of the General Medical Council, the government body referred to as Britain’s medical watchdog. It seems that the GMC is controlled by physicians, some of whom are directly elected to membership by the profession itself.
While not holding it responsible for the crimes of Dr. Shipman (who hanged himself in his jail cell last January), Dame Smith said “Having examined the evidence, I have been driven to the conclusion that the GMC has not, in the past, succeeded in its primary purpose of protecting patients. Instead, it has, to a very significant degree, acted in the interests of doctors.”
Her report then went on to recommend a number of measures, the result of which would be to dilute the control that the medical profession has over the discipline of physicians and, ultimately, to remove that control altogether if the performance of the GMC does not improve.
A profession is understood to involve specialized knowledge and skills not possessed or comprehended by the laity. It follows that oversight of the performance of those within the profession should be the responsibility of the profession itself since no one outside the profession would be competent to do it.
Dame Smith threatens to take responsibility for the oversight of medical practice away from physicians. To a considerable extent, that has already happened in the U.S.
Does that mean that medicine no longer qualifies as a profession?
