Title
Guild interests: an insidious threat to professionalism in obstetrics and gynecology
Publication Date
2018
Journal Title
Am J Obstet Gynecol
Abstract
© 2018 Elsevier Inc. Powerful incentives now exist that could subordinate professionalism to guild self-interest. How obstetrician-gynecologists respond to these insidious incentives will determine whether guild self-interests will define our specialty. We provide ethically justified, practical guidance to obstetrician-gynecologists to prevent this ethically unacceptable outcome. We describe and illustrate 2 major incentives to subordinating professionalism to guild self-interest: demands for productivity; and compliance and regulatory pressures. We then set out the professional responsibility model of ethics in obstetrics and gynecology to guide obstetrician-gynecologists in responding to these incentives so that they preserve professionalism. Obstetrician-gynecologists should identify guild interests affecting their group practices, set ethically justified limits on self-sacrifice, and prevent incremental drift toward dominance of guild self-interests over professionalism. Guild self-interests could succeed in undermining professionalism, but only if obstetrician-gynecologists allow this to happen. When guild self-interest becomes the deciding factor in patient care, professionalism withers and insidious incentives flourish.
Volume Number
219
Issue Number
6
Pages
581-584
Document Type
Article
Status
Faculty; Northwell Researcher
Facility
School of Medicine; Northwell Health
Primary Department
Obstetrics and Gynecology
PMID
DOI
10.1016/j.ajog.2018.09.007