The Medical Professionalism Blog

This is the second in a series of posts written by the ABIM Foundation’s Putting the Charter into Practice grantees, which describes their motivation to pursue projects related to stewardship of resources.

I’ve been interested in good stewardship as long as I can remember. It must be connected to the admonishments of my parents not to waste. Whatever the effects of my early upbringing might have been, witnessing as a 1^st-year medical student a two-class health care system characterized by waste on one hand and deprivation on the other convinced me that wise use of clinical resources could help achieve a more just health care system.

That was in 1968. Today, the situation is both worse and more dire. Our political system is mired in ideological gridlock. We must look to ourselves, as physicians, for a solution.

The “Top 5″ lists generated by the NPA’s Good Stewardship Project, funded by a previous Putting the Charter into Practice (PCIP) grant, will not solve our nation’s health care problems, but can serve as a clarion call to all physicians of every specialty to recognize their professional obligation to use clinical resources wisely.

With our new PCIP grant, we will produce a video showing physicians a simple, five-step approach to use with patients as they put the Top 5 lists into practice. Our hope and expectation is that as the lists’ recommendations are implemented, physicians will cultivate a new mindset that will guide their clinical practice more broadly.

Never has the need been more urgent for physicians to step up and do the right thing. We fervently believe that we will and we thank the ABIM Foundation for giving us the chance to prove it.

Stephen R. Smith, MD, MPH is professor emeritus of family medicine at the Warren Alpert Medical School of Brown University in Providence, Rhode Island. He retired in 2007 as associate dean, a post he had held for 25 years. During his tenure as associate dean, Dr. Smith earned an international reputation for innovation in medical education. He was the architect of the competency-based curriculum at Brown that has been replicated at many medical schools around the world.

Since his “retirement,” Dr. Smith has been working part-time in the community health center in his hometown of New London, Connecticut, and organizing physicians in Connecticut for the National Physicians Alliance (NPA). He also served as the principal investigator of an NPA project funded by the ABIM Foundation to promote good stewardship in primary care. He earned his medical degree from Boston University School of Medicine in 1972 and his master of public health degree from the University of Rochester in 1977.