How things change

It is rumoured that the GMC is supporting web sites which make recommendations on the quality of particular doctors. This is what the GMC used to say:

Doctors should not ....... cause, sanction or acquiesce in the publication of their names or practice details in any professional directory or book which purports to make recommendations as to the quality of particular doctors or their services.

Advertising - Guidance from the General Medical Council
Published 1995
Withdrawn 1997

How it be so wrong to do this in 1997 and so right in 2008? Is this about the death of professionalism?

The reason we don't advertise is that, contrary to what many are now trying to tell us, medicine is more than a commercial activity. The GMC itself used to agree with Dr Grumble:

The promotion of doctors' medical services as if the provision of medical care were no more than a commercial activity is likely both to undermine public trust in the medical profession and , over time, diminish the standards of medical care which patients have a right to expect.

GMC
Withdrawn 1997

What has caused the GMC to change its view? Why is it now all right for a doctor to set up practice in, say, some heavily advertised Virgin polyclinic and get a cut when he refers a patient for some doubtfully efficacious Virgin add-on therapy? If patients want alternative treatment that is fine. But they must go into it with their eyes open and we as a profession must not collude and make commercial profits from our collusion. This is about trust, the trust the GMC mentioned in the quote above but now seems to have forgotten. When a patient sees a doctor they should feel confident that they are getting advice that is not tainted by the needs of commerce. That doesn't always happen. But that should be the aim. The fact that mostly it does happen, especially in general practice, may well be why the public trust doctors so much. Patients need to be able to trust their doctor. We must preserve this trust at all costs.

Professional self-regulation emerged in the 19th century. It was not just doctors. Lawyers, auditors, architects and engineers did the same. They did it to set standards, maintain public trust and to prevent the public being exploited by unscrupulous charlatans.

This need has not gone away. Far from it.