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March 7, 2013 at 12:09 PMComments: 0 Faves: 0

Must Doctors Always Be Honest?

By Jeffrey VanWingen M.D. More Blogs by This Author

Recently, a doctor from Johns Hopkins University was caught videotaping his patients unclothed in exam rooms. When confronted, the doctor admitted to the allegations. Before charges could be brought, he killed himself in his home.

This story is unnerving to me in so many ways. Primarily, it feels like a member of my own team, that esteemed calling of medical professionalism, let us down. Medicine holds a pretty good reputation, so things like this weaken that notion. But this occupation is made up of humans knit together of the same weaknesses as the rest of society. With that said, should doctors be held to higher standards of righteousness and honesty?

The Roots of Professionalism

Long before medicine began winning its battle with disease, a high ethical bar was set. The Hippocratic Oath dates back to Greece in the fifth century BC and serves as a pledge to practice ethically and honorably. Regarding conduct, the oath leads doctors to commit that,  "In purity and holiness I will guard my life and my art." In other words, doctors must be pure not only in medicine, but also in their private lives.

Presently, a different standard still exists in the practice of medicine, which encompasses things similar as well as new issues that could never have been conceived of in ancient Greece. Numerous internet websites rank doctors on a number of factors; money spent on a doctor by a pharmaceutical representative (bringing in cookies for his office staff, for instance) must be reported by law and can be viewed online by the public; practice guidelines painstakingly supported by research guide actions for treatment.

Must Personal Life Mirror Professional Practice?

Can a doctor cheat on his taxes and still be trusted to provide good, ethical medical care?  In the calling of medicine, as in the calling of the church, the requirement exists to "practice what you preach." There's no room for double standards. This includes our views on health and wellness, ethical conduct, and honesty.

The government and professional medical societies agree. In a case of physician tax evasion, the state of California reasoned that it could not "compartmentalize dishonesty in such a way that a person who is willing to cheat his government out of $65,000 in taxes may yet be considered honest in his dealings with his patients." This doctor lost his license to continue providing medical care.

The Reality

Doctors are people too and are, therefore, not perfect. To follow suit, I am not perfect. But, I took my oath seriously, and I strive to practice honest, ethical medicine and make my personal life mirror this conviction. I still consider medicine a high calling and feel privileged to serve within it. I see it as something to be earned on a regular basis, devoid of entitlement. In other words, I continually owe medicine for the honor to practice. Medicine (or my patients or the government) doesn't owe me anything beyond what I earn fair and square.

Sadly, with pressures and cuts from the government and health insurance companies, along with more stringent requirements and guidelines, doctors are feeling pressed into a corner. When backed into a corner, animal instincts can come into play, lashing out. This pressure or tendency may come in the form of cutting corners, rationalizing dishonest billing, or cheating in some other way. 

Disciplinary actions against doctors are on the rise, and these issues may be part of the issue. 2011 data reveals 6,034 actions taken against US doctors. Statistically, men were three times as likely to get into trouble compared to their female counterparts. As far as the different specialties, OB/GYN, family doctors and psychiatrists were the most frequent offenders, while pediatricians and radiologists were the least likely to get into trouble. In general, as age increased, so did prevalence of actions warranting discipline.

In Conclusion

The practice of medicine is a calling which demands integrity. While times have changed dramatically through the ages regarding the delivery of this art, the sentiment of the Hippocratic Oath has not wavered. And it shouldn't, considering the privilege which doctors hold, caring for the carefully balanced health of their patients.

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