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Medical Writings |

The Remains of the Profession, or What the Butler Knew

Ellen S. More, PhD
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Dr. More: University of Texas Medical Branch; Galveston, TX 77555-1311

Presented in preliminary form at the McGovern Symposium on Professional Values in the Art of Health Care Practice, Galveston, Texas, 6 March 1999.

Acknowledgments: The author thanks Professors Michele Carter, Albert Jonsen, and Laurence McCullough for helpful comments.

Requests for Single Reprints: Ellen S. More, PhD, University of Texas Medical Branch, Galveston, TX 77555-1311.

Ann Intern Med. 2001;134(3):255-259. doi:10.7326/0003-4819-134-3-200102060-00030
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Forty percent to 50% of physicians today are salaried employees (1). The rapid transformation of the independent practitioner into the employee-practitioner has prompted widespread debate about the potential erosion of medical professionalism, especially physicians' autonomy and integrity (25). This essay was prompted by a rereading of The Remains of the Day(6), Kazuo Ishiguro's brilliant novel about an English butler's moral awakening, against the background of these concerns.

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