Abstract
Preventive care is considered a benefit to the patient. Physicians express a positive attitude towards prevention, but their performance of recommended activities is low, as shown in a five-year trial at the Seattle VA Medical Center. The release of the U.S. Preventive Services Task Force’s guide to clinical preventive services has provided physicians with authoritative prevention recommendations. While most physicians are specialists with little interest or skill in preventive care, primary care providers do accept an obligation to provide comprehensive care, including prevention. This paper examines the ethical basis for the idea of obligation. External pressures, legal, economic, and organizational, are affecting the physician—patient relationship in ways that encourage a contract mode of medical practice and limit physicians’ ability to provide preventive care. As a profession, medicine needs to speak for the health needs of the public. As practitioners, physicians need to seek the welfare of their patients.
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Received from the Division of General Internal Medicine, University of Washington, and the Veterans Administration Medical Center, Seattle, Washington.
Supported in part by the Department of Veteran Affairs.
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Belcher, D.W. Are physicians obligated to provide preventive services?. J Gen Intern Med 5 (Suppl 2), S104–S107 (1990). https://doi.org/10.1007/BF02600853
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DOI: https://doi.org/10.1007/BF02600853