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May 1993

The Physician as Professional and the Physician as Honest Businessman

Author Affiliations

From the Center for Ethics, Baylor College of Medicine, Houston, Tex.

Arch Otolaryngol Head Neck Surg. 1993;119(5):495-497. doi:10.1001/archotol.1993.01880170019003

Some attention is beginning to be paid in the recent literature of bioethics and health policy to a variety of ethical issues that arise in the business aspects of the practice of medicine. These include such questions as advertising in medicine, physician self-referral, physician fees, and conflicts of interest in clinical trials. These questions arise primarily, but not exclusively, in those settings in which physicians practice fee-for-service medicine, and there are many such settings in the United States and elsewhere. I want to suggest that the controversies surrounding these issues result from neither society in general nor physicians in particular having decided which of two models of the physician is the more appropriate model, and that progress in resolving these issues requires an unequivocal adoption of one of them. In the first section of this article, I will present an outline of these two models. In the next two sections,

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