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‘Doctors look set to become much less central to health care’ argued a recent editorial in The Economist. The piece went on: ‘Resources are slowly being reallocated. Nurses and other health workers will put their training to better use. Devices will bolster care in ways previously unthinkable. Doctors meanwhile will devote their skill to the complex tasks worthy of their highly trained abilities. Doctors may lose some of their old standing. But patients will clearly win’.1
Healthcare professions have always questioned their role in society—it could be argued that it is a professional responsibility so to do—but in a world still reeling from the 2008 financial crash, such arguments are now framed as much in economic as philosophical terms. And as the most costly of the healthcare professions, it becomes more important than ever to have a clear answer to the question, what do doctors do? Or perhaps more provocatively: why are doctors necessary? What benefits do they bring to society? What is expected of a physician, let alone the ‘good’ one?
This was, of course a question addressed by Abraham Flexner over 100 years ago in his report on medical education in North America.2 Flexner's report went on to become profoundly influential and underpins much of the way in which doctors are educated today as well …