In the July 11 issue of the American Medical News, AMA president Peter Carmel, MD shares his thoughts in a commentary describing the necessities that knowledge, empathy, and integrity are to the physician. His lines on 'knowledge' and 'empathy' are fine, the sort of rah-rah boilerplate perfect for first-year med students.
Then Carmel starts the windup, quoting an ancient admonition against greed, and re-describing that as a modern physician's unfounded sense of entitlement. He walks the banal path of non-controversy, warning that "we must never trade our objectivity for a steak dinner or a spa weekend." (Luxury weekends aside, only a fool would waste an evening hearing a drug pitch without a decent meal, and maybe a cocktail.)
And then Carmel walks across a deadly line: "We must never let the desire for personal autonomy stand in the way of patient interests. We call that integrity."
In one horrifying, amazingly succinct statement, the AMA prez has told us what is wrong with his duplicitous organization, and indeed with our entire system. No valid patient interest would ever, could ever threaten the autonomy of his physician. Without the autonomy of one's mind - and its employment - there can be no integrity. Through inference, to denigrate the rightful autonomy of the doctor is to set him on a level lower than the patient, and to make him a servant of whatever system is devised around him. There is nothing in the Classical Hippocratic oath that calls for a physician to be less than his patient, and Carmel's statement is proven to be antithetical to the Western tradition of defending the individual.
Carmel goes on to laud the AMA's work against U.S. obesity, and explain how his bunch of apparatchiks are making it easier to comply with the CMS directives. Doctors surrendered their autonomy in the mid-1960's to a system that the AMA has celebrated ever since through initiatives such as these. Sure, maybe the AMA president meant greed, and unethical enrichment, but that's not what he said. What he said was precisely in line with the AMA's longstanding betrayal of the individual, patient and doctor alike.
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