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The Journal of Bone and Joint Surgery 82:1189 (2000)
© 2000 The Journal of Bone and Joint Surgery, Inc.

The Orthopaedic Forum

Professionalism and Medicine's Social Contract*

Richard L. Cruess, M.D., Sylvia R. Cruess, M.D. and Sharon E. Johnston, M.A.

The Centre for Medical Education McGill University 1110 Pine Avenue West Montreal, Quebec H3A 1A3, Canada E-mail address for R. L. Cruess: rcruess@med.mcgill.ca
*No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article. Funds were received in total or partial support of the research or clinical study presented in this article. The funding source was The McConnell Family Foundation, Montreal.

The role of the physician in modern society has undergone an extraordinary transformation in the past few decades31,42. Those who entered practice a generation ago had almost unquestioned authority, could usually pick their geographic location and mode of practice, and generally had substantial control over the method and amount of remuneration as well as over their lifestyle. The resources allocated to health care were expanding, and science was providing new and exciting methods to relieve human suffering. Physicians were treading relatively familiar paths, perpetuating patterns and practices of medicine that they believed were part of its tradition. Finally, they genuinely felt that as professionals they were providing useful services both to their patients and to society and thus were engaged in a noble calling. As the medical profession, including orthopaedic surgery, faces a new century, much has changed and medicine's response has often been defensive and insensitive to the . . . [Full Text of this Article]


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