There is a reference to the concept of  “nobility obliges” as far back as Homer’s Iliad.  The super hero Spiderman hears something similar from his uncle.  The essence of this phrase is that when you have attained a certain real or perceived higher status in life much more is, and should be, expected of you.  A French novelist by the name of Honore de Balzac is credited with first penning the phrase “Noblesse Oblige” in a novel by the name of “Le Lys dans la vallée” published in 1836.

Medicine has been referred to as one of the noblest professions.  It is certainly a profession that ideally requires a degree of commitment and selflessness beyond all others.  Years of training attempting to understand, now at the nano-level, the complexities of the human body both in health and disease followed by a lifelong quest to stay current with the ever-changing bio-medical literature.  Then a daily battle to apply all of this information to a very heterogeneous population of human beings.   There is an incredible and unmatched responsibility in having another human being ask for assistance with maintaining the quality and/or quantity of their life.  Public opinion polls support the fact that people respect the profession and trust their providers (physicians and nurses).  In addition to the respect and trust afforded physicians the profession is also assigned a great deal of prestige and esteem.

The prestige and esteem (i.e. nobility) assigned to the profession of medicine does come with expectations (i.e. obliges).  The expectations/obligations are simply to live up to the high prestige and esteem that are associated with the  profession.  Physicians are expected and obliged to first and foremost be educated and compassionate advocates for the health care needs of every patient that they encounter.  There is an expectation that a physician will maintain competency in his or her specialty by ongoing professional education.  There is an obligation for physicians to practice their profession and apply their skills with an understanding that each patient deserves to be evaluated and treated  as an individual.  There is not an expectation for a perfect outcome every time but an obligation for a physician to always work toward a perfect outcome every time.

There are expectations that physicians should have of each other and obligations to each other and to the profession.  There should be an expectation that physicians work together always putting the patient first.  There should be an understanding that each specialty has unique skills and that it is often necessary to coordinate all of these skills for optimal patient care.  There is also an incredible obligation for physicians to protect the profession from external forces that want to reduce the practice of  medicine to an assembly line mentality.

So in summary the practice of medicine is still respected and looked upon as an esteemed and prestigious profession.  Those that hold the profession in high regard rightfully have expectations of the profession.  Physicians must continuously work to live up to and even exceed these expectations.  It’s an obligation that comes with the job.