The Physician's Oath

Just as all public servants, physicians take an oath. It is the oath that sets physicians apart from other people in society. The oath has nothing to do with moral or intellectual superiority. Neither does it confer upon the physician a duty to present themselves as an avatar of health, or to appear infallible.

The oath is actually quite simple. Although there are a few different versions out the, the core admonition is the same: First Do No Harm.

To uphold this basic principle of medicine is the first duty of any physician. The reason that governments require physicians to obtain a license is that the practice of medicine inherently poses a great threat to public health and welfare. It is an uncomfortable reality that those who are in a position to cause the most benefit to health also bear the most risk of causing harm.

Especially in the case of an acute health crisis, decisions must be made which can have miraculous or disastrous consequences. Mistakes do happen; things get overlooked. Often times, we choose to risk one outcome in order to help prevent against another. I don't think there are too many who would fault a physician for making a difficult decision in an acute life threatening situation.

But are we taking too many unnecessary and expensive risks in chronic care?

The average physician today is caught in a bind. Their oath is requiring them to act in one way, while the health care system is requiring them to behave in another. When a doctor recommends a drug or a surgical procedure, it is often with good reason. However there are often good reasons to use treatments which pose much lower levels of risk.

It is a sign of the times when efforts are underway to further limit access to safe, effective, proven alternatives to drugs, even as scandals continue to erupt from the pharmaceutical industry. Vaccines tainted with viruses. Outright falsification of research. Massive recalls of over-the-counter medications.

Meanwhile, the medical establishment largely discourages use of dietary supplements.

There are now volumes of peer-reviewed research supporting the use of dietary supplements for just about every health condition. There are journals dedicated to the topic and several textbooks written with contributions from respected physicians and scientists in every field. Opinions may continue to differ over specific points in the literature, but outright denial of the evidence can only be made in complete ignorance or out of willful desire to mislead the public.

The oath does not require physicians to first recommend the treatments which are most supported by double-blind placebo controlled studies or large scale clinical trials. Rather it commands to use those which pose the least harm first.

Physicians are meant to be servants of the public, not servants of the health care system. Though there is a lot that can be done to change the system, a physicians oath and duty will remain the same: First Do No Harm.