Viewpoint: Improving the health of the public requires changes in medical education

It has been widely accepted and recommended that the needed improvements in the quality of health care require fundamental reforms in medical education. However, it is essential to recognize that there are significant problems not only with the quality but also with the quantity of health care in the United States. The medical profession has to confront the fundamental moral problem of unrealized rights and unattained justice in health care that has resulted in explicit harm to the health of a large portion of the population. Does this state of affairs have anything to do with the ways physicians have been educated about civic responsibilities, leadership, and professional integrity? What kind of education is to be provided for what kind of physicians and for what kind of medicine? Emphasis should be placed on the leadership role and on the underlying attitudes and values of physicians that reflect the morality of medicine. The doctor-patient and doctor-society relationships are part and parcel of the moral and professional responsibilities of physicians. Different moralities are involved when medicine is practiced as a job or business or vocation, because these entail different dispositions toward patients and society. The envisioned educational changes should challenge and prepare physicians not only with regard to their knowledge and skills but also with regard to their moral and professional integrity and leadership, so they may serve individuals and society in a health care system that ensures equal access to high-quality services for all.