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Does Profit Seeking Hurt the Practice of Medicine?

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Does Profit Seeking Hurt The Practice of Medicine?

There are two oppositional points of views at this arguable model. On the one hand, professor of medicine Arnold S. Relman argues that financial and technological pressures are forcing our doctors to act like businessmen while, in fact, they should not look at their affair as at business. This pressure may have deleterious consequences for patients and for whole society in general, Relman says. On the other hand, Andrew C. Wicks, an assistant professor at the University Of Washington School Of Business, does not agree that there is the perceived contrast between physician ethics and business ethics. Moreover, he proposes to look at these fields, business and medicine, a bit closely and we will reveal fundamental similarities. Further, he adds that having business ethics in the ethics of medicine is beneficial for both doctors and patients.

Relman starts his argument by identifying a conflict between altruists (doctors) and egoists (businessmen). He argues that medicine should operate on an "Altruistic Model" while business operates in "Oppositional Model. Thus, he first emphasizes the way of how doctors are obligated to fulfill their duty in regard to the patients. Throughout their entire way to get permission to cure people, the doctors were taught to believe that their duty to the patients should be always more important to them than their own economic interest. It is actually very important universal issue. We do not have to mix the business and medicine affairs. Then he points out that in order to be a genuine profession of medicine, a doctor has to be a pure altruist caring and advising patients on their health-needs. These altruistic actions have to be only in the interest of their patients. However, federal government and insurance companies of patients provide enough financial sources to doctors to make a successful living.

In contrast to doctor's duties, businessmen are free to act in absolute egoistical approach. It is up to them to decide how they should make their profits. For example, if I want to buy a car, I go to dealer. His primer goal is to gain on me because this is his job. Otherwise, he would not survive. It is ridicules if he will give me the best car for the cheapest price without gaining anything one me. Thus, he does not care about me. My needs are not important for him. All his actions are egoistic. But, I can chose either this dealer or another because buying a car is not question of death of life, and I have time to look for it. However, in case of medical needs, patients do not have ability to choose, which care is better for them. In most cases patients even do not have enough time to choose. Let us say, for example, the disease is on urgent level. Consequently, these patients will totally depend on the doctors, who are expected to be altruistically interested in these patients' needs.

According to Relman, these two fields - business and medicine are absolutely different and if we will combine them, the net result will not hurt business area, but it will definitely bring a total destruction for the medicine.

But, what makes doctors think less about their patients and more about themselves just like businessmen. Don't they earn enough to make a living? Are they so bad? By answering this question, we could see why Relman does not support the concept of free market. Relman is trying to say that it is not the doctors who are putting people into commodity. Not, they are not so bad, but antitrust legislation makes bad system. The complex set of regulation restricts the physicians to act as altruists. However, what can the physicians do? Relman says, "The physicians have a power to make health-care reform possible".

Nowadays, there is a great deal of expansion in the medical industry. All medical facilities, centers, and costs have increased dramatically that lead in high competition for patients. Thus, doctors are expected to lose their patients, and suffer financially. However, tuition of medical school is extremely high and most of the physicians take a great deal of loans. This debt has to be repaid somehow. Another headache is cost of practicing. All these researches need money to be spent and because of that any doctor, who just started his career and speeded a lot of money for practice, also expect to be reimburse. Thus, we see that there is a huge investment and liability that supposed to be recovered.

In addition, Relman brings an example that at least a third of all nonpublic health - care facilities are now operated by investor-owned businesses such as nursing homes, private psychiatric hospitals, and free-standing therapeutic diagnostic facilities. All these investor-owned health-care businesses receive profits from public and private health insurance companies. We have to do everything, doctors think, in order to be in touch with patient's insurance company because otherwise another medical office will take this profit from us. Thus, the law system leads altruism to unethical - for medicine business greedy. Relman thinks this is the net result of free market.

Therefore, the increases in service facilities directly lead to competition and to seek for profit. Moreover, since it drives medical industry to act in the competitive way, it also makes service suffer. Patients are get over- treated. When a patient comes to doctor he/she is billed anyway even if he/she did not have any health problem. This is how doctors work, this is how they survive, and this is how the system makes them behave even though there is a de facto contract between society and doctors.

By looking at these facts, Relman shows us that the whole idea of altruism falls apart. Instead of providing their patients the best possible care or advice, doctors are now searching for the best possible way to make profit on their patients. This approach can harmfully hurt the health of the patients. Just like on the market, "practicing physicians have begun to use advertising, marketing, and public-relations techniques to attract more patients." These patients are not patients anymore, they are clients or customers.

Now, after viewing all these decisive Relman's arguments, we should take a look at them from absolutely different perspective that is proposed by Andrew C Wicks. Wicks disputes with Relman's approach of "the oppositional model," with that profit seeking causes over treatment, and he solves this problem by offering the Balanced Model.

First of all, Wicks is trying to re-conceptualize how we think about both medicine and business. He says it is not right to identify doctors as pure altruists and businessmen as egoists. However, even if Relman's approach is right, where businessmen are pure egoists and doctors are pure altruists,



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