The following is a quote from Dr. Perednia advocating votes for DrRich. Unfortunately, the ACP blog won out.
Dr. Rich's blog has been nominated for an award for the Best Health Policy/Ethics Blog on the Internet. His chief competitor is the blog of the massive and politically powerful ACP - the American College of Physicians. The most important difference between these two competitors is their attitude toward the physician-patient relationship. The ACP has decided to endorse a "new set of ethics" in which "social justice" considerations (whatever the hell they are), should be taken into account along with the personal welfare of the patient when making medical decisions and dispensing medical advice. Specifically, physicians should engage in "parsimonious care", that is designed to minimize the use of medical resources and "ensure that resources are equitably available".
To put it bluntly, the ACP is saying that when you're lying there with a potentially fatal or crippling condition, your doctor has an obligation to think not only about what's best for you, but also about what's best for "society" in terms of what tests to perform, what medications to prescribe and what procedures to undertake. They don't actually say who actually gets to dictate the needs of "society", but it's a reasonable guess that your insurance company, government regulators, Medicare, the AMA or ACP, or some other "official" entity will be making the call. "Normally Mr. Jones, I'd recommend that you get a CT or MRI test to make sure that you aren't having a stroke or a tumor that we would treat immediately, but a 'panel of experts' has decided that it's best for society that we order these tests parsimoniously. So I'm going to have to think about this one for a while. I'm sure you understand. Tell me if you develop any further weakness and we'll reconsider at some point in the future."
I would strongly encourage you to read Dr. Rich's discussions of these differences in perspective and their implications here, here, here and here. I would point you to the ACP's responses to Dr. Rich's arguments, but they've declined to publish any on their own websites.The issue of the primacy of the physician-patient relationship, the fiduciary duty of the former to the latter and its erosion by the "new" medical ethics has been something talked about much on this blog (see here for a recent comment). I am heartened to see another voice in fray.