A warning to physicians that they were failing to face up to the threats now confronting the medical profession across the world, has been delivered by Dr Delon Human, secretary general of the World Medical Association.

Addressing a Greek Medical Association conference in Athens, Dr Human said the medical profession might now be in a phase of its history where it was not focused enough, and might even be guilty of hubris about what was necessary for the profession not only to survive, but also to prosper.

He said that physicians should understand the trends they were encountering.

"The practice of medicine has been completely changed by the Internet and information technology. The threat to the profession in this regard is if we do not adapt and all use the technology to serve our patients and ourselves, instead of the other way round".

There was a threat to the profession from the limit to economic resources and the fact that clinical decision-making would eventually be forced into a situation of financial decision-making. This could cause irreparable damage to the patient-physician relationship.

Dr Human warned: "We should be especially careful of being branded as a self-serving profession and should always stay on the high road of being the patient's best advocate and partner in health."

He said that these and other threats could be illustrated from around the world by examples such as the Korean physicians' strike over a new law prohibiting the dispensing of medicine and enabling pharmacists to diagnose and treat illnesses, or the threat to physicians in Chile from a wave of North American Health insurance companies entering the health care market.

In countries like Australia, New Zealand and the Philippines, where health care services were provided by both the private and public sectors, physicians were finding it difficult to keep their patients even though the public sectors could not cope with the demand for services, while in South Africa physicians in the public sector could not treat patients with AIDS with the best possible treatment, because it was unaffordable.

Dr Human said that on the movement towards preventive and promotional health, physicians were reluctant to take the lead, allowing nurse practitioners and pharmacists an ideal opportunity to expand their professions.

He warned that in the USA and UK there had been a positive increase in sophisticated systems of professional self-regulation and if physicians did not get their act together, somebody else would.

Dr Human said the patient-physician relationship was unique within the health care professions, and was the single most important competitive advantage the medical profession had. "Patients generally trust us - and we shall literally lose our profession if we lose that trust".

He urged physicians to re-establish their role as the central leader of the health care team and chief caretaker of patients by strengthening their knowledge and understanding of the art of medicine, by improving their clinical skills and by paying much more attention to skills of communication.

Finally he said that physicians were not involved enough in the political areas. "If you do not speak up and become involved as social leaders in this country, be sure your politicians will plan the system around you."