Doctors have been warned to be careful about being branded as a self-serving profession.

Addressing a medical conference in Taipei, Taiwan, Dr Delon Human, secretary general of the World Medical Association, said that physicians worldwide should always stay on the high road of being the patient's best advocate and partner in health.

He said there were six clear global trends which were now facing individual physicians:

• The inability of public sector health care systems worldwide to cope with demand for health care services and in response to that, the expansion of the private health care sector
  
  
• A trend of medical practice away from specialization. Cost constraints had caused a decline of hospital care in favour of out-patient or home care, and a much greater emphasis on generalist care
  
  
• A movement towards preventive health, where, because physicians were reluctant to take the lead, nurse practitioners and pharmacists were being offered an opportunity to expand their professions;
  
  
• A definite shift towards measurable quality. Driven by patient-demand for outcomes-measurement, especially in the USA and UK, there had been an increase in sophisticated systems of professional self-regulation. If doctors did not get their own act together, somebody else would;
  
  
• A significant shift from an unmanaged fee-for-service system, where private health care services were provided, to one where costs were managed.
  
  
• The increasing role of technology in medical practice.

Dr Human said that in response to these trends, physicians had to defend vigorously their fundamental ethical principles:

Physicians should always treat patients as they would like themselves to be treated, and put the patient's interests above their own;

Physicians should maintain a position of technical and moral independence, so that it was never necessary to make decisions against their conscience and not in the best interest of the patient;

The patient should always have the right to choose their own physician or change physicians if necessary;

Medical confidentiality should remain a basic principle of medical ethics;

The physician had a duty to protect the rights and interests of the patient at the level of public health.