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It has been aptly stated that trying to predict the future based on the past is like trying to drive your car by looking in the rear-view mirror. Thus, every indication suggests that the healthcare delivery system of the future will little resemble that of the past. Envisioning a new and better healthcare system could be reassuring if that new system results in a healthier America. The more complex question is how the future of the medical profession melds with the future healthcare delivery system. In order to reaffirm the role of physicians in healthcare, we as physicians must recognize the power that we hold, and use it for the good of our profession, now.

Physicians must recapture the role of patient advocate. Our professionalism is based upon the knowledge and skill set we acquired through rigorous education and training. We can do better than arbitrary performance metrics. Care is about caring. Physicians understand the devastating consequences of disease better than anyone. We understand the powers of placebo and of hope. We understand that ‘doctor’s advice’ is powerful medicine. We need to make time to listen. We can do better than patient satisfaction scores.

Medicine is a profession. Professions are characterized by a high degree of autonomy and judgment - professional judgment. People and disease are complex, which is why medical training is long and intense. Protocols can be deceptively easy and the data on which yesterday’s protocols are based may be biased and flawed, or old and outdated. There is nothing wrong with best practices and with minimizing variation, but a sick person is not a widget, and is best served with individualized care. Protocols make medicine easy; we need to make sure that we never sacrifice the best medical care for the easiest plan of care.

Physicians are physicians. Professions typically enjoy social status, regard and esteem which are based in the higher social function of their work, which is regarded as vital to society as a whole and thus of having a special and valuable nature - professional expertise. There is nothing wrong with the respect conferred upon professionals who have earned that designation. Physicians are not simply providers and to accept that designation means that we are losing professional pride, and professional status. We physicians need to remember that we went to medical school, at some sacrifice and when there is talk about bringing value to the patient care encounter, we need to stand up and be counted. More