The January 2002 Ideas paper says that while doctors continually struggle to balance the financial demands of corporate-driven health care with the needs of patients, physicians by virtue of affluence and public trust are in a prime position to advocate beyond the needs of an individual patient and bring greater equity to the delivery of health care.

"Physicians must challenge a system of care that is structured on behalf of shareholders and speak out on setting new national health care priorities," say David J. Rothman, Ph.D., chairman of the board of advisors of the Medicine as a Profession (MAP) program at OSI and Tom O’Toole, M.D., program officer for MAP at OSI-Baltimore.

"If the medical profession is to fulfill the covenant that exists between the doctor and the patient, a new order of professionalism marked by advocacy and collective action has to emerge," add Rothman and O’Toole, co-authors of the feature Ideas article, "Physicians and the Body Politic; Redefining the Dimensions of Care."

Rothman has written extensively about the history of medicine, as well as current health policy and practice, ethics of human experimentation, and medical professionalism. O’Toole is a general internist on the faculty at the Johns Hopkins University School of Medicine where he is the associate director of the Urban Health Institute and conducts health services research related to access to care for vulnerable populations.

Ideas also profiles the work of Dr. Michael Fine, M.D., a Soros Advocacy Fellow and a Rhode Island family practitioner who is part of a growing movement within the medical community that recognizes the importance of population-based intervention strategies. "Physicians need the community organizing skills to approach the population base," Fine says.

According to Fine, the challenge is to make community organizing, often driven by instinct and experimentation, become legitimate in the medical community, which is taught to act on conclusions rather than hypotheses.