To the Editor.
—JAMA will never print a more important article than the patient-physician covenant.1 It strikes to the very heart of our professional being and to the core of our relationship with those we serve. It is correct and timely.
The physician-patient relationship is indeed based on trust. Other models that postulate a business, contractual, or other basis ignore the moral nature of our profession and the role it has played down through the centuries.
De facto reform of the health care system is now taking place. It is based not on the principles espoused by Hillary Rodham Clinton and Ira Magaziner, those of Health Access America, or the myriad other proposals put forward in recent years. It is being reformed by the reckless and ruthless application of raw economics to a system that deserves more thoughtful modification.
The concepts embodied in the covenant constitute the last
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