Views of medicine as a profession

The editorial on the question of whether medicine is still a profession1 is disingenuous. Does the author really believe that the “commercial moral syndrome” is the sole domain of “private companies”? If so, he or she has not had much contact with a university research laboratory and the frenzy of grant-writing at certain times of the year. Is academic gain and advancement somehow more laudable than commercial gain? Both have a profit motive, and both may or may not benefit patients and society at large. I have heard distinguished academics deliver distorted and limited descriptions of a topic in support of their research, and physicians paid by government agencies often deliver messages that clearly pander to the payer and not to scientific honesty.

To mention just one example, the “commercial moral syndrome” has delivered biologic agents that have transformed the treatment of inflammatory arthritis. If that syndrome has also resulted in monetary profit, is that sinful? Many of the advances in therapeutics, both medical and surgical, would not have occurred without the beckoning of “tawdry profit.”

It is surely our responsibility as professionals to analyze and critique any information that we might be given, or that we might search out on our own, to formulate the best synthesis of the data. If we are to be restricted by a sanctimonious few to the information that those few consider “appropriate,” we are victims of censorship.

I wonder about the fate of publications such as CMAJ if the proposals in this editorial were enacted. What would the subscription price be? How would the many editors be paid? Who would be the arbiter of those who are deemed to possess the “guardian moral syndrome” and, accordingly, who would be allowed to educate us all?

The system of continuing medical education and medical publishing as it currently exists is democratic. And, like a democratic political system, it is imperfect but better than anything else.