During these tough economic times we've heard much about greed as an underlying cause of the down turn. Everyone from Wall Street investors, CEO's of giant corporations, with their "golden parachutes", politicians, Fannie and Freddie, to homeowners who got loans interest free, without any credit are said to be at fault.

Greed is not new in our Nation's history. During the decade of the 80's (the Reagan era), many critics called it the decade of greed even though charitable giving increased substantially.

Few physicians are immune to the pleasures and benefits of money. We like to buy attractive homes and luxury cars, we send our kids to the best schools, and we take comfortable and interesting vacations. One of the greatest challenges a physician faces is the challenge of a successful practice. After many years of hard work and training and delayed financial gratification it is easy to get caught up in the whirlwind of economic success and let it impact one's practice. Medicine is not beyond reproach when it comes to greed. To a large extent the public perceives physicians as highly successful business people functioning with a business ethic; hence the rash of advertising and the rush to add procedures and services that are often outside of the physicians scope of training. Too many of us start out wanting to do good and end up wanting to do well. It can no longer be assumed that the good of patients is the transcending commitment for all physicians. Some have taken on the ways of those Wall Street executives and practice money rather than medicine. They will charge whatever the traffic will bear. Perhaps greed should be considered an impairment or an addiction and handled much like alcohol and drug abuse.

The practice of medicine has always had one foot in the business world and one as an advocate for our patients, but we must do all we can to protect that advocacy. In the rush to become successful business people physicians risk losing the quality of caring which has been the beacon of public trust in our profession. Commercial interests within the context of medicine can bias even the most devoted physician but a commitment to caring for the patient may ameliorate this somewhat. As Francis Peabody wrote in 1927, "One of the essential qualities of the clinician is interest in humanity, for the secret of the care of the patient is in caring for the patient."

John J. Mohr, MD