Professional courtesy is a practice that has outlived its usefulness. Today it stands in the way of a physician and his family getting the best care available. It is an anachronism which in the modern medical milieu defeats the noble purpose it was originally intended to serve. Physician attitudes toward each other and their patients should be an integral part of the ongoing ethical discussion, starting at the beginning of medical school and continuing on throughout one's medical career. The concept and implications of professional courtesy should be included in these discussions because they go to the heart of getting and giving the best care available.
Major criticisms against doing away with professional courtesy are that this somehow denigrates the medical profession, removes the aura of medicine, casts a shadow on its nobility, and somehow translates itself into the idea that money is what is good about medical care. We feel the central concept of the doctor-patient relationship (no matter who the patient is) should be a special sense of caring. However, not charging for care makes it different for the patient and the physician. Both may feel compromised. Both may feel the loss of freedom to react. Charging for care says that the patient's needs are significant, deserve attention, and that the doctor's services have value.
Pediatrics, perhaps more than any other specialty, requires frequent communication and visits between physician and patient and entails extensive use of the telephone. We feel that because of professional courtesy many physician-parents and their spouses are deterred from using pediatric services appropriately by timely office visits or telephone calls. They therefore do not receive optimal care.35
In starting practice, the young physician must make a decision when he sees his first doctor-patient. Although he may have never been taught about the concept, somewhere in the back of his mind is a thought that Hippocrates said physicians should not charge other physicians for care, and so he establishes a precedent of professional courtesy that usually remains through a lifetime of practice and is very difficult to change or abandon. It is therefore at the start of practice that the disadvantages of professional courtesy should be most carefully considered. We recommend not starting the custom. But even if it has already been started, we recommend that this anachronism be abandoned.
The Ralph and Melissa Daniel Young Physician Nail Merit Award 2018
