Simplistic Rambles on Independence
Independence as defined by Webster the state or quality of being independent; freedom from the influence, control, or determination of another or others. As we move "forward" from the pioneer days to these modern technological times, has the great spirit of the independent settler regressed? In a similar vein, is our practice space being invaded? Again: Is our independence being restricted? Again: but this time more aggressively and by more powerful forces. While, as a physician, I believe being independent is essential for therapeutic decision making; it is never without responsibility or the consequence. Any party affecting the treatment process must also share the liability. This is a negative freedom process. In medicine we rationalize that it is very desirable, if not essential, we be free from external influences so that we can be unencumbered in patient care decisions. However, we do vacillate in defining what is considered interference or even dictatorial as compared to educational or tutorial. It seems, to us, that the latter two are considered benign influences as they are primarily for updating medical knowledge and technology aimed at improving patient care. While the former two, in physicians' minds, are construed as being motivated more by financial and power gains than patient care benefits. Should anyone group have the right to decide, independently, diagnostic, therapeutic, and financial aspects of medical care? Physicians are specifically trained and licensed to perform the first two, i.e., diagnosis and treatment: we do not claim any other expertise. However, we do acknowledge that there are other aspects of health care outside of the strictly medical sphere. All members of the