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The Hippocratic Oath

Contemporary Version

(satire)

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[1] I swear by Apollo, the Physician, by Asclepius, Hygieia, and Panacea, and I take to witness all the gods and goddesses, to keep according to my ability and judgment the following oath:

[2] To consider dear to me as my parents those teachers who taught me this art but did not inform me of the terrible climate in which I would have to apply this skill and never pointed out to me the great difficulty I would have in repaying my student loans or the virtual impossibility of starting a private practice with the current cost of professional liability insurance. Despite this, I shall look after my teacher’s children as my own children, but will thoroughly acquaint them with the realities of practice as it is today. I will reveal to any of my offspring who aspire to join our profession the terrible pressures of the practice of medicine today, including professional liability, restricted freedom in the methods of treating illness and the use of hospitals and the prescribing of medications, and the hostile relationship with patients that has developed because of the insidious rationing of health care by DRGs, regulations of health maintenance organizations (HMOs), and so on.

[3] I will prescribe regimens for the good of my patients according to my ability and judgments but never  violate the rules of Medicare, Medicaid, HMOs, preferred-provider organizations—PPOs, and the like. I will never keep a patient in the hospital longer than the DRG allows or the HMOs and PPOs suggest, regardless of the inconvenience to my patient. I will always use generic drugs, even if I think the proprietary drug is more effective. I will always obtain a second opinion, even if I do not think that one is necessary and the patient does not wish one. I will try to ration the resources spent on my patients in line with federal, state, and insurance company mandates.

[4] As required by law, I shall share with federal and state agencies, insurance companies, professional review organizations, and the like all strictly confidential information that has come to my knowledge in the exercise of my profession. Like any businessman or businesswoman, I will observe all antitrust laws. Should I and my colleagues, with only the most honorable of intentions, meet to set and maintain professional standards or eliminate excessive fees, may the Federal Trade Commissioner suitably punish us for our noble efforts.

[5] If I keep this oath faithfully, may I survive this hostile medical environment long enough to discover an alternative career so that I may enjoy life respected by all people and in all times. But if I swerve from it or violate it, may the reverse be my lot.*

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Barry M. Manuel, M.D., The New England Journal of Medicine, 318/8 (Feb 25, 1988), pp. 521-2.