The more things change, the more they stay the same
Nearly 100 years ago, George Bernard Shaw, in the preface to his play The doctor’s dilemma, savagely attacked the medical profession for its direct personal and pecuniary interest in the treatment of patients and argued that doctors could not be trusted to act in their patients’ best interests.1 He observed that medicine was not driven by science but rather by patient demand and service. Nor was Shaw particularly impressed with medical science, noting that “medical science is as yet very imperfectly differentiated from common curemongering witchcraft”. In short, he argued that the medical practice of his time was mostly ineffectual and that doctors should advise patients that wellness is not attained through a bottle of medicine but through decent housing, clothes, food and clean air. The doctor’s dilemma was that providing this advice would jeopardise his already meagre income.
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I appreciate the discussions on this topic with Ruth Armstrong, Kerry Breen, John Chalmers, William Coote, Stephen Leeder, Rick McLean, John O’Dea, George Rubin, Ian Scott and Richard Smallwood. The editorial is entirely my responsibility.