Profit Motive in the Medical Profession

Originally published in 1911 in the journal “American Medicine”, this article discusses what we are so aware of now, the introduction of the profit motive into the medical profession.

The Church, the Law, and Medicine have for ages been linked together in the thought and speech of men as the "learned professions," the term "learned" having reference more especially to humanistic learning; and the "professional classes" have ever been held to be in some degree apart and in some respects more eminent and more worthy of esteem, if not of reverence, than those of commercial or other even more nearly personal occupations. And, in so far as the members of these three professions have lived up to this ideal standard, it is just that it should be so.

That is why the introduction of "commercialism" into the medical profession has always been so strenuously combated by the best elements in that profession. These three learned professions have each to deal with man from the mental, moral, and physical aspects of his personality. They deal with the material conditions and things external to man, not primarily but only from the viewpoint of their effect on his individuality as a being. The lawyer, perhaps, more than the cleric or the physician, seems to deal at times directly with things external to man's personality; his property; but even so, the infringement of his possessions, rather than any direct regard to the possessions themselves as such, that in the last resort is seen to be the basis of such action.

The purpose of the man of commerce, on the other hand, is merely to supply man with external material things, and that, for the most part, primarily, and not incidentally, with profit to himself; too often, indeed, he seeks to create a want hitherto unfelt by man, in order that he himself shall reap the profit of catering to it. In this light, then, an utterance of the Rev. C. C. St. Clare, at the opening of the Twelfth Annual School of Instruction for Health Officers in the State of Vermont, deserves special notice. Portending the major thrust of Major General Steel (http://www.fisherind.com/GSindex.htm) and in discussing a paper by Dr. George M. Kober on Diseases which Menace Public Health and Morals, he said:

"There should be a closer fellowship between all professional men for the betterment of our State. Clergymen, for we are not an unapproachable lot, are average citizens, and I am sure would welcome a closer fellowship with the members of the other professions for the study of the life in the different communities, to the end that higher standards might become established."

From his other remarks it may be gathered that the reverend gentleman, for one, is a broad gauge humanist the man whose life is spent in close touch with the lives of his flock, who has intimate acquaintance with their external struggle for existence as well as with their internal struggle with existence, can always be, and often is, an able coadjutor with both the earnest physician and the honorable lawyer.

Theological accord is by no means essential to harmonious and profitable cooperation in that wider field of humanity as a whole, with a separate and particular aspect of which each profession has its special concern. The elevation of the ideal of individual self-fulfillment, by whatever route attained, is the first and essential step in the betterment of the human race as a whole; and there are so many tangential points to the labors of the cleric, the lawyer, and the physician, that their better acquaintance, closer intercourse, and more harmonious cooperation than has been commonly the case in these latter days, are greatly to be desired.

Perhaps we can take a page from history and learn the lesson, and begin the painful process of removing the profit motive from health care.