Abstract
The public’s trust in physicians continues to decline. As a way to begin regaining this trust, stakeholders, including physicians, medical educators, patient advocacy groups, and community-based organizations, have called for medical education to meet societal health needs, particularly the needs of those members who are most vulnerable, by incorporating social accountability into the medical school curriculum. The unique attributes of the osteopath-ic medical profession provide an enabling and conducive environment for broader social accountability in the health care system. Osteopathic medical schools must actively safeguard the profession’s unequivocal commitment to producing healers that are fiduciaries for their patients, communities, and populations at large.
Those who choose to study and practice the healing science and art of medicine pledge a commitment to society to be competent, altruistic, and ethical. Yet, a 2014 study
1 revealed that 42% of US adults surveyed disagreed with the statement, “All things considered, doctors in [your country] can be trusted” and reported that during the past 50 years, trust in physicians has decreased dramatically. To address this issue, several stakeholder groups and individuals (eg, physicians, medical educators, patient advocacy groups, community-based organizations) in the United States and abroad are calling for medical education to focus more on meeting society’s health care needs, particularly among those populations that are marginalized and most vulnerable to disparities in health outcomes.
2 Meeting the health care needs of all members of society in this context requires preparing sufficient numbers of primary care physicians to work in underserved areas, training physicians to collaboratively address the social determinants of health using population-based health measures, and reforming a professional identity to explicitly focus on empathy and social justice. In the words of the preeminent educator, Ernest L. Boyer, PhD, “the crisis of our time relates not to technical competence, but to a loss of the social and historical perspective, to the disastrous divorce of competence from conscience.”
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The call to physicians to reaffirm their duty to society comes with the realization that there is sufficient evidence
4 of the detrimental effects of the social determinants of health and related disparities in health outcomes (biological, social, and environmental). Hence, the concepts of social responsibility and health advocacy are becoming a fundamental element of both medical education and practice.
5 Although this call for educational reform includes a commitment to public safety, society expects medical educators to instill and nurture future physicians with social responsibility and health advocacy in their ethics, empathy, community service, interprofessional collaboration, and lifelong learning. Greater transparency and broader participation in social accountability is needed to determine how future generations of physicians are admitted to medical school, trained, and held responsible for meeting the health care needs of society.
6 Patients can be disadvantaged when it comes to the lack of transparency around the cost of health care services and products—a transparent system provides quality reporting and disclosure of financial relationships that may lead to a compromise in fiduciary relationships with patients.
7 Further, transparency helps patients choose physicians wisely and inspires physicians, hospitals, and other providers to improve their performances.
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