Medicine's rising costs put Hippocratic Oath at risk

In most medical schools, students recite the Hippocratic Oath together to mark the start of their professional careers. The soon-to-be physicians swear to uphold the ethical standards of the medical profession and promise to stand for their patients without compromise. Though the oath has been rewritten over the centuries, the essence of it has remained the same: "In each house I go, I go only for the good of my patients." But the principles of the oath, says Gregg Bloche, MD, are under an "unprecedented threat." In The Hippocratic Myth, Bloche details how doctors are under constant pressure to compromise or ration their care in order to please lawmakers, lawyers and insurance companies. Bloche says that doctors are increasingly expected to decide which expensive tests and treatments they can and cannot provide for their patients. Their dual role as examiner and cost-cutter can then potentially compromise patients' care, he says, particularly when insurers and hospital administrators urge physicians to only perform "medically necessary" treatment.