“The most important thing is caring, so do it first, for the caring Physician best
inspires hope and trust.”
Sir William Osler
The WMA is a federation of National Medical Associations (NMA) representing over 8
million physicians in >85 countries around the world. It was founded in 1947 with
the mission to “serve humanity by endeavoring to achieve the highest international
standards in medical education, medical science, medical care, and medical ethics,
and health care for all the people of the world”. Despite the enormously disparate
environments and circumstances in which physicians care for patients, there are three
fundamental, unifying, and enduring traditions of the medical profession; caring,
ethics, and science. Thus, it is not surprising that physicians' desires and concerns
are similar globally.
Recent surveys of physicians in over 40 countries around the globe reveal their concern
about access to quality safe medical care, appropriate professional autonomy to provide
that care, and adequate resources and facilities to deliver care. They are seriously
concerned about the regulatory, legal, political, and other barriers to their care,
and governments' attitudes that medical care is an expense, a cost, not an investment
with positive return despite the global data indicating otherwise. To a large degree
they felt marginalized, threatened, and their professional values and status demeaned.
They requested the WMA provide increased information on health systems and greater
exchange of experience between physicians throughout the world. The physicians requested
vigorous communication of the values of the medical and health professions and the
well documented value in relieving distress, despair, disease, disability, and premature
death and the extraordinary return on investment in medical care and public health.
Physicians also felt they needed to enhance their knowledge and skills in advocacy
for patients, the public health, and the medical profession.
With the partnership of NMAs and the Pfizer Medical Humanities Initiative, the WMA
formulated and implemented a multipart program to address these concerns and objectives.
The first, Phase I of the Caring Physicians of the World Initiative, was outreach
visits by WMA officers to many NMAs and regional meetings of NMAs to learn more directly
about circumstances, needs, and desires, and to obtain their participation in advocacy
for the values of the medical profession. Within a year, 55 NMAs had selected physicians
that exemplified the highest standards of caring, ethics, and science; 65 of them
were profiled in a book The Caring Physicians of the World . Phase II of CPWI was
launched in Santiago, Chile at the WMA Annual meeting. Subsequently, communications
with NMAs, medical specialty societies, government, media, businesses, philanthropies,
and multiple other public and private associations and organizations were provided
the message of the Caring Physicians of the World (Introduction enclosed).
Phase III of the CPWI was collaborations of the WMA and NMAs to hold regional meetings
around the world to enhance understanding, communication, and advocacy for patients,
the public health, and the medical profession. Physicians profiled in the book were
especially honored at these events as examples of the power of our traditions of caring,
ethics, and science to kindle hope and trust and instill enthusiasm and optimism.
These characteristics are common to successful leaders. Thus, it is not surprising
that the physician leaders profiled were social leaders as well, on behalf of the
public's health, scientific progress, society's resources, and the welfare of humankind.
Advocacy and leadership were addressed in Phase IV of the CPWI. December 2–9, 2007
thirty-four colleagues selected by their NMAs participated in a course at INSEAD in
Fontainebleau, France designed to enhance knowledge, skills, and abilities to use
the power of our traditions, patients, friends and colleagues along with new skills
and knowledge, to advocate and organize more effectively for medical care, education,
research, ethics, and our profession. Feedback has been extraordinarily positive as
has the communication between the ‘Alumni’ of the course. The Indonesian Medical Association
(IMA) has used the momentum of the INSEAD course to implement its own Caring Physicians
Initiative. The IMA, in collaboration with their Minister of Health, will present
the Caring Physicians of Indonesia Book at the President's Palace on May 28th to launch
their centennial anniversary of the IMA.
Despite the unparalleled progress in biomedical science, public health and medical
care, the threats of communicable and non-communicable disease progress. The barriers
created by ineffective, inefficient, and sometimes corrupt, governments, legal systems,
and institutions flourish. The public is confused by terms, such as providers instead
of professionals, customers instead of patients, health care instead of medical care,
and the pollution of scientific information by media and distortion by legal and regulatory
systems. They are understandably distrustful. However, because of the justifiable
enthusiasm physicians have for the value and values of their profession and the ability
to be useful, there is good reason to be optimistic that effective leadership, hard
work, clear definition of responsibilities and rights as a profession serving people,
patients and the public, and a mission beyond self, will result in significant and
The CPWI is not foremost about medicine or about doctors. The center focus is about
people, about patients. The CPWI is about the right of all patients to choose physicians
providing care based on a singular ethical commitment to them, using the best available
science, in a caring manner. The right for their physician to have appropriate autonomy
to provide care and to be their advocate. Fulfilling aspirations to provide ethical
and science-based care is important. However, as Osler said, caring is the most important
part because it best inspires hope and trust. Thus, it is crucial that physicians,
despite the diversity and adversity of circumstances, be able to communicate that
caring, through their courtesy, respect and aequinamitus on behalf of the patient.