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Medical professionals decry marketplace medicine Copyright © 1997 Nando.net Copyright © 1997 Reuters CHICAGO (December 2, 1997 6:23 p.m. EST http://www.nando.net) - More than 2,300 U.S. doctors and nurses issued an open letter Tuesday accusing health care companies of turning their profession into one where profits count more than compassion and care. "Physicians and nurses are being prodded by threats and bribes to abdicate allegiance to patients, and to shun the sickest, who may be unprofitable," the letter said. "Some of us risk being fired or 'delisted' for giving, even discussing, expensive services and many are offered bonuses for minimizing care. "Mounting shadows darken our calling and threaten to transform healing from a covenant into a business contract," it added. The letter, titled "A Call to Action," was published in this week's Journal of the American Medical Association and came from the Ad Hoc Committee to Defend Health Care. It was signed by more than 2,300 doctors and nurses in Massachusetts. A similar group in Illinois said more than 4,500 other medical professionals around the country have signed similar documents in their states. The letter said the Massachusetts group had petitioned state officials there to slap a moratorium on for-profit takeovers of hospitals, insurance plans, health maintenance organizations, physician's practices and other health care institutions. It suggested members of the profession should seek the same thing in other states "pending the development of comprehensive state and national policies" and said patients need to be educated about the issues. The letter said not-for-profit hospitals, visiting nurse agencies and even hospices are being taken over by companies "responsive to Wall Street and indifferent to Main Street" who can sometimes get profits of $100 a day per patient. "Canons of commerce are displacing dictates of healing, trampling our profession's most sacred values. Market medicine treats patients as profit centers," the letter said. "The time we are allowed to spend with the sick shrinks under the pressure to increase throughput, as though we were dealing with industrial commodities rather than afflicted human beings .... "The right to choose and change one's physician, the foundation of patient autonomy and a central tenet of American medicine, is rapidly eroding," the letter added.