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February 26, 2007
First, do no paperwork
by Peter Pitts
Greek physicians of the Hippocratic period would not treat patients they didn’t think they could “cure.” They felt that it was bad for the patient (“First, do no harm”) and bad for their reputation. This latter point may seem shocking today, but it was not exceptional in ancient medicine – in fact, it was an integral part of the prognosis.
When such a situation arose, the ancient Greek physician resigned himself to what was called “noble flight.” (Also, it should be noted, an early example of health care “spin.”)
But such a thing could never happen today, right?
Well, hopefully – but the current debate over pay-for-performance is opening up the debate among many physicians about the wisdom of accepting difficult to treat patients. What’s old is new again. Consider M&M conferences? While never pleasant, they do serve an important purpose. Imagine if physicians avoided cases they couldn’t “cure.” In such a circumstance, we’d be right back to the time of the ancient Greeks.
After all, is the fear or damage to one’s reputation really any different than fear of reduced payment?
Posted by Peter Pitts at February 26, 2007 09:27 AM
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