The Southern Medical Journal (SMJ) is the official, peer-reviewed journal of the Southern Medical Association. It has a multidisciplinary and inter-professional focus that covers a broad range of topics relevant to physicians and other healthcare specialists.

SMJ // Article

Perspectives

The Patient-Resident Physician Covenant

Authors: Benjamin W. Frush, MD, MA

Abstract

Twenty-five years ago, a group of physicians argued for what they called the “patient–physician covenant.”1 “Medicine is, at its center,” they claimed, “a moral enterprise grounded in a covenant of trust.” They were responding to what at the time appeared to be an increasingly complicated relationship between physicians and commercial interests, with growing financial incentives, pressure to serve as gatekeepers to goods and services, and the increasing legitimacy of material self-interest on the part of providers and the profession as a whole. In the face of these changes, the authors affirmed that medicine is best practiced not merely as a professional undertaking but as a “special kind of human activity” that requires certain traits of character, such as humility, honesty, and intellectual integrity, for its fulfillment.

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References

1. Crawshaw R, Rogers DE, Pellegrino ED, et al. The patient-physician covenant. JAMA 1995;273:1553.
 
2. May WF. Code, covenant, contract, or philanthropy. Hastings Cent Rep 1975; 5:29–38.
 
3. Tilburt J. Shared decision making after MacIntyre. J Med Philos 2011;36: 148–169.
 
4. Mata DA, Ramos MA, Bansal N, et al. Prevalence of depression and depressive symptoms among resident physicians. A systematic review and meta-analysis. JAMA 2015;314:2373–2383.
 
5. Curlin FA. Conscience in the practice of the health professions. https://www. consciencelaws.org/ethics/ethics112-004.aspx. Published September 11, 2008. Accessed November 4, 2021.
 
6. Hartzband P, Groopman J. The new language of medicine. N Engl J Med 2011;365:1372–1373.
 
7. Hafferty W, Franks R. The hidden curriculum, ethics teaching, and the structure of medical education. Acad Med 1994;69:861–871.