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May 1990

Professionalism and Medicine

Arch Ophthalmol. 1990;108(5):634. doi:10.1001/archopht.1990.01070070020004

To the Editor.  —In his article in the December 1989 issue of the Archives, Dr Sacks correctly asserts that ophthalmology is evolving through an enforced agenda of deprofessionalization.1 This process is not unique to medicine. The ultimate legacy of the 1960s may be the eclipse of such traditional authority figures as politicians, physicians, and the clergy. Nonetheless, the agency role of the physician is so critical to the healing process that the loss of professional status may be the preeminent cost of the commercialization of health care to both physician and patient. To the physician, the loss of autonomy is implicit in this cost.If it is agreed that deprofessionalization is harmful to the physician, is it harmful to the patient? The answer is not clear, but there exists the potential that the loss of autonomy, control, collegiality, and adherence to tribal law and ethics without satisfactory compensation will