Private practice unethical says UK doctor


6 May 2015

Private medicine is unethical as it encourages doctors to make decisions on the basis of profit rather than need, says a UK cardiologist who believes doctors should practice in private or public but not both.

Writing in a viewpoint in the BMJ John Dean, a consultant cardiologist said it was unethical for doctors to practice both privately and for the NHS health service and they should give up one or the other.

He says he had always been ambivalent about private practice, and had become increasingly uncomfortable with his own involvement.

“I realised that, in all conscience, I could not go on with it. No matter how high I set my own moral and ethical standards I could not escape the fact that I was involved in a business where the conduct of some was so venal, it bordered on criminal—the greedy preying on the needy,” he wrote. 

According to Dean the business of medicine and the practice of medicine are at odds. Private medicine encourages doctors to make decisions on the basis of profit rather than need, he says.

“When confronted with a choice between two treatment pathways in equipoise—one that earns the doctor no money and the other with a fat fee attached—that conflict is stark. 

“Let’s face it: the whole business is largely a con. Patients think that paying must mean higher quality medicine, but—like paying more for shampoo with added vitamins—the promise is far greater than the reality,” he writes. 

Dean has given up private practice and says he doesn’t miss it, describing the release of “the  burden” as liberating.

He never hankered after a Maserati car, a chalet in the Swiss Alps, or fine dining anyway he says, declaring himself as more of a chicken balti man. 

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