The vocation to serve: cornerstone of health care.

Twenty-five hundred years ago, Hippocrates bequeathed a set of ethical precepts that emphasized the social transcendence of the practice of medicine and the profound commitment of physicians to serve patients and their families selflessly and with a pure heart.[1] Traditionally, small-town medical practice facilitated spontaneous interpersonal relationships between family doctors and nurses and their patients. Later, however, centralization of health services in large medical complexes, an explosion of technology not always wisely deployed, litigiousness, tabloid journalism and commercialism in health service provision have created conditions that are, to say the least, less than propitious for optimal satisfaction on the part of patients and families. In my view, this has been accompanied by a dangerous devaluation of clinical skills, of medicine as a vocation, and by deterioration in the relationship of physicians and other health professionals with patients and their families.