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I would not consider myself old… yet. When I was in medical school (starting to feel old now), I remember a small group of my classmates meeting with a fifty-something, community physician for a rare “medicine in real life” moment. I do not recall his exact words, although I do recall him being pleasant and cheerful. I also remember him reporting that he found his work satisfying, but my memory of this encounter had an indelible quality of discouragement.

Whether it was implied or stated, the message I received was "If I had it to do over again, I would not have chosen medicine." Having already made my decision to pursue medicine, I was determined that I would not be deterred. In the last handful of years, this memory has begun to haunt me. I am not saying I regret choosing medicine, but I have begun to understand his ambivalence.

The practice of medicine is not what I was expecting. While I have the tremendous benefit of practicing a craft that affords me regularly with a satisfaction that few craftsmen realize, there is something else there that I did not anticipate. The specter of my mentor’s ambivalence has moved front and center. The forces of commerce have inserted themselves into the very heart of the doctor-patient relationship.

Hippocrates, by all accounts the father of modern medicine, identified science and the natural (as opposed to the supernatural) forces that result in wellness and disease and spawned evidence-based medicine by emphasizing the importance of listening to and observing the patient. Hippocrates—I don’t think—could have imagined that, one day, this sacred relationship would be slowly encroached upon by those that sought to commoditize it. Now, entities, many of which add little or no value to the relationship, profit off of it through brokerage, arbitrage, hook, and crook. This intrusion of commerce into the doctor-patient relationship has been a lucrative pursuit for many, but overall patient well-being (and doctor well-being for that matter) has suffered tremendously as a consequence.

This blog was birthed out of the need to speak out against the commoditization of this critically important collaboration between a healer and those in need of healing. My intended readers are both patients, physicians and physicians-to-be and my intended goal is to help to close the divide and to heal the damage that commerce has wrought on the doctor-patient relationship, our health and wellness, and this noble craft. I want to send a different message to those succeeding me. Choose medicine, just choose to make it better. This blog, essentially a therapeutic journal made public, is not a how-to guide. But, my hope is that my perspective and my musings may speak to and inspire the key players at stake, doctor and patient, and spark real and much needed change in our infinitely capable but currently broken system.

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