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The Physician and the Civic Self

Don E. Detmer, MD
JAMA. 1980;243(14):1463-1464. doi:10.1001/jama.1980.03300400047032.
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How does a physician serve? How should he serve? Peter Dans, MD, has written a quietly provocative article on physicians and health policy that makes a number of apt observations about physicians and the "big picture" (p 1451). He presents these views in the context of a brief description of the Institute of Medicine's Robert Wood Johnson Health Policy Fellows Program (not to be confused with the Robert Wood Johnson Clinical Scholars Program)—a program that has been a success by all indications. Since its inception, competition for the fellowships has been keen. But what happened to the fellows themselves after leaving the program? What of their reentry? Have the physicians among them remained clinically active? If not, should they have? How should these physicians serve? How should any physician serve?

For centuries the socialization process in medicine has overwhelmingly emphasized the values of philanthropy and "technophilia." Historically, physicians have held


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