International Journal of Integrated Care, 29 January 2010 - ISSN 1568-4156
Section on Special Initiatives Relevant to Person-centered Care
World Medical Association's Caring Physicians of the World Initiative (CPWI)
Yank D. Coble, MD, MACP, MACE, Former President World Medical Association, Director and Distinguished Professor, Center for Global Health and Medical Diplomacy, University of North Florida, Jacksonville, Florida
Correspondence to: Yank Cable, E-mail: y.coble@unf.edu

“The most important thing is caring, so do it first, for the caring Physician best inspires hope and trust.”

Sir William Osler

The WMA is a federation of National Medical Associations (NMA) representing over 8 million physicians in >85 countries around the world. It was founded in 1947 with the mission to “serve humanity by endeavoring to achieve the highest international standards in medical education, medical science, medical care, and medical ethics, and health care for all the people of the world”. Despite the enormously disparate environments and circumstances in which physicians care for patients, there are three fundamental, unifying, and enduring traditions of the medical profession; caring, ethics, and science. Thus, it is not surprising that physicians' desires and concerns are similar globally.

Recent surveys of physicians in over 40 countries around the globe reveal their concern about access to quality safe medical care, appropriate professional autonomy to provide that care, and adequate resources and facilities to deliver care. They are seriously concerned about the regulatory, legal, political, and other barriers to their care, and governments' attitudes that medical care is an expense, a cost, not an investment with positive return despite the global data indicating otherwise. To a large degree they felt marginalized, threatened, and their professional values and status demeaned. They requested the WMA provide increased information on health systems and greater exchange of experience between physicians throughout the world. The physicians requested vigorous communication of the values of the medical and health professions and the well documented value in relieving distress, despair, disease, disability, and premature death and the extraordinary return on investment in medical care and public health. Physicians also felt they needed to enhance their knowledge and skills in advocacy for patients, the public health, and the medical profession.

With the partnership of NMAs and the Pfizer Medical Humanities Initiative, the WMA formulated and implemented a multipart program to address these concerns and objectives. The first, Phase I of the Caring Physicians of the World Initiative, was outreach visits by WMA officers to many NMAs and regional meetings of NMAs to learn more directly about circumstances, needs, and desires, and to obtain their participation in advocacy for the values of the medical profession. Within a year, 55 NMAs had selected physicians that exemplified the highest standards of caring, ethics, and science; 65 of them were profiled in a book The Caring Physicians of the World [1]. Phase II of CPWI was launched in Santiago, Chile at the WMA Annual meeting. Subsequently, communications with NMAs, medical specialty societies, government, media, businesses, philanthropies, and multiple other public and private associations and organizations were provided the message of the Caring Physicians of the World (Introduction enclosed).

Phase III of the CPWI was collaborations of the WMA and NMAs to hold regional meetings around the world to enhance understanding, communication, and advocacy for patients, the public health, and the medical profession. Physicians profiled in the book were especially honored at these events as examples of the power of our traditions of caring, ethics, and science to kindle hope and trust and instill enthusiasm and optimism. These characteristics are common to successful leaders. Thus, it is not surprising that the physician leaders profiled were social leaders as well, on behalf of the public's health, scientific progress, society's resources, and the welfare of humankind.

Advocacy and leadership were addressed in Phase IV of the CPWI. December 2–9, 2007 thirty-four colleagues selected by their NMAs participated in a course at INSEAD in Fontainebleau, France designed to enhance knowledge, skills, and abilities to use the power of our traditions, patients, friends and colleagues along with new skills and knowledge, to advocate and organize more effectively for medical care, education, research, ethics, and our profession. Feedback has been extraordinarily positive as has the communication between the ‘Alumni’ of the course. The Indonesian Medical Association (IMA) has used the momentum of the INSEAD course to implement its own Caring Physicians Initiative. The IMA, in collaboration with their Minister of Health, will present the Caring Physicians of Indonesia Book at the President's Palace on May 28th to launch their centennial anniversary of the IMA.

Despite the unparalleled progress in biomedical science, public health and medical care, the threats of communicable and non-communicable disease progress. The barriers created by ineffective, inefficient, and sometimes corrupt, governments, legal systems, and institutions flourish. The public is confused by terms, such as providers instead of professionals, customers instead of patients, health care instead of medical care, and the pollution of scientific information by media and distortion by legal and regulatory systems. They are understandably distrustful. However, because of the justifiable enthusiasm physicians have for the value and values of their profession and the ability to be useful, there is good reason to be optimistic that effective leadership, hard work, clear definition of responsibilities and rights as a profession serving people, patients and the public, and a mission beyond self, will result in significant and measurable success.

The CPWI is not foremost about medicine or about doctors. The center focus is about people, about patients. The CPWI is about the right of all patients to choose physicians providing care based on a singular ethical commitment to them, using the best available science, in a caring manner. The right for their physician to have appropriate autonomy to provide care and to be their advocate. Fulfilling aspirations to provide ethical and science-based care is important. However, as Osler said, caring is the most important part because it best inspires hope and trust. Thus, it is crucial that physicians, despite the diversity and adversity of circumstances, be able to communicate that caring, through their courtesy, respect and aequinamitus on behalf of the patient.

Reference
1.
Nigel, Duncan, editor. Caring physicians of the world. Ferney-Voltaire (France): World Medical Association; 2005.