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Marketing and ethics
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To the Editor:
I am somewhat disappointed with the Round Table, “Panel discusses the ethics of marketing an orthopedic practice,” published in the August 2013 issue. My disappointment was first provoked by the fact that the word “ethics” was only mentioned once.
The panelists seemed to endorse advertising and marketing of orthopedic surgeons and their practices. They implied that such a means is perfectly legitimate and appropriate. This position contradicts the millennia-old tenet that medicine is a profession, not a business. Rather than attempting to balance tradition with current societal changes, they chose to support the latest fashionable trend.
The changes experienced by our profession within a single generation have been profound. Endless and continuous greater profit, which is the ethos of business, is becoming that of the medical profession. Ironically, this is exemplified by the virtually overnight replacement of the Aesculapius emblem, which shows a snake wrapped around a shaft, with the emblem of Hermes, the god of commerce, thieves and others, which depicts the shaft with two snakes intertwined around it. What is the Freudian interpretation of this event?
No one summarized the old medical tradition better than Chief Justice Warren Burger who, while addressing the American Medical Association a few decades ago, said, “I will never trust a physician who finds it necessary to advertise his practice.”
Apparently without concern, contemporary society has experienced profound changes in long thought to be sacred precepts. They are declared to be archaic, obsolete or irrelevant, to justify their dismissal. The changes are declared to be a sign of inevitable healthy evolution. Is it always evolution or sometimes devolution? Is it a sign of progress or “madness on the loose,” as Michael Novak claimed?
Regardless of the changes, which many, including myself, consider pernicious, we have the responsibility, for the sake of the future of our discipline and society as a whole, to address the challenge that advertising of physicians poses to our profession. I would suggest that Orthopedics Today either reconvene the panel or create a new one to study in greater depth the ethical implications of the issue at hand.
Augusto Sarmiento, MD
Miami
Disclosure: Sarmiento has no relevant financial disclosures.
Dr. Romeo responds
Ethics can be defined as the moral principles that guide a person’s or group’s behavior. The panel considered the moral principles that may guide physicians when they market their practices. Marketing is a form of education, and many patients and other groups find that information is valuable to match their needs with the expertise and service of medical care providers.
While the idealism that medicine is an art remains among our peers, many other professionals who greatly impact our lives believe physicians are a commodity that can be easily replaced. We have to make an effort to understand and participate in the business of providing medical care, or we will be subjected to the ethics of individuals and groups who control our profession. They are less likely to have the same moral principles that guide our lives and devotion to better patient care.
Anthony A. Romeo, MD
Chief Medical Editor