There is an ongoing heated debate concerning the best possible model for a
healthcare system able to respond to public expectations. Society wants
changes – radical changes – that place the organisational apparatus of the
current healthcare system in a critical position. Public opinion, as well as the
opinion of the medical profession, reflects doubts concerning the ability of
physicians to preserve their current role in serving patients.
Control over people’s health in terms of prevention, as well as care, has
rendered the management of the healthcare system more and more complex.
The budget is so conspicuous that it has an important role in the economies
of even the most industrially advanced countries. In such a context, it is difficult
to know with absolute certainty whether future physicians will have professional
autonomy and the ability to excel in their role as healthcare
providers, or whether their role, of necessity, will be submerged in, and secondary
to, bureaucratic and administrative considerations. This second possibility
is a cause of great concern among physicians, who are conscious of
their changing role in society and the progressive decrease in personal prestige.
The reality of the situation is reflected in the increasing tendency of the
relationship between physician and patient to become impersonal.