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OPINION
Jean Jacques Rousseau, who argued that society should take priority for things that don’t really matter.
over the individual, and that whatever meaning there is to be found Those whose perspectives align with Kierkegaard naturally re-
in individual life must be defined by its meaning for society, to which
the rights of every individual are ultimately subordinate. gard the healthcare tumult of the day from a somewhat longer per-
spective, one that treats the freedom of individual physicians and
In medicine, Rousseau’s outlook may be restated this way: Indi- patients as intrinsic goods that deserve to be protected and pro-
vidual physicians are first and foremost workers in a larger system moted for their own sake, independent of their effect on the bot-
of healthcare, and their work must be regulated by the needs of tom line.
the healthcare system as a whole. The professional freedom and
fulfillment of individual physicians are important only to the de- Ultimately, Drucker would say that it is out of the tension between
gree that they serve these ends. the Rousseaus and Kierkegaards of contemporary healthcare that we
must strike the appropriate balance between a fully rationalized
Drucker regards Kierkegaard as providing perhaps the only vi- healthcare system and a way of practicing medicine that respects the
able alternative to Rousseau. If Rousseau represents the pragmatic dignity and humanity of individual physicians and patients.
concerns of society, often represented in medicine by healthcare
corporations, licensing boards and accrediting agencies, then Where, why and how Drucker thought we should strike this bal-
Kierkegaard represents something like the timeless ideals of the ance will be the subject of the author’s talk at noon March 13 the
profession as embodied in the heart of each professional. University of Texas Health Science Center San Antonio. The event
is cosponsored by UTHSCSA, The Patient Institute and BCMS.
LONGER PERSPECTIVE Richard Gunderman, MD, PhD, is the Chan-
Those who seek to rationalize the practice of medicine according cellor’s Professor of Radiology, Pediatrics, Medical
Education Philosophy, Liberal Arts, Philanthropy
to sound business principles, transforming physicians from pro- and Medical Humanities and Health Studies at In-
fessionals with minds of their own into reliably homogeneous fol- diana University and a contributing writer for The
lowers of established policies and procedures, believe that, in the Atlantic.
end, no freedom can be allowed in the practice of medicine except
visit us at www.bcms.org 23
