Doctor as scientist, healer, magician, business entrepreneur, small shopkeeper, or assembly line worker — which is it?

Bernard Lown, MD
June 26, 2012
In the tumultuous debate about health care convulsing public discourse, the focus is on escalating costs and possible economic remedies. But the innards of the ailing system have not been adequately exposed to searching analysis.
Health care systems are stressed by a burgeoning global population, multiplying in my lifetime 3.5 fold, to seven billion. They are distorted by the increasing dominance of market forces, focused primarily on profitability rather than patients’ well-being. They are mal-aligned by growing inequities in wealth between developed and developing countries, and by the decimation of the middle classes in industrialized countries. They are challenged by adverse ecological transformations that afflict us with puzzling new diseases as well as with drug-resistant microbes and viruses. Life on earth is undermined by the chemicalization of ecosystems, the pollution of air and water, and climate change threatening the planet as a comfortable habitat for human civilization. This veritable witches’ brew has other malign elements, most noteworthy the commoditization of everything within market reach, including art, education, and religion — ensnaring the most intimate of human interactions as well as our inner selves. The result is the alienation of people from their communities, families, friends, and ultimately themselves./.../