Initially, James Gorman appears to be stating that physicians should not be ethically obligated to treat each and every slob that seeks treatment. The title of the essay and the sarcastic tone give evidence that the thesis is quite the contrary. Gorman does identify an alarming trend of physicians looking through a cynical eye with an example of a survey by the American Medical Association, published November, 1991. Thirty percent of doctors surveyed said they felt no ethical responsibilities to treat AIDS patients. This seems to set the tone of disgust for such physicians.
Gorman further condemns such physicians by reminding the reader…doctoring is a profession, a calling requiring commitment and integrity. Gorman confirms his argument with the first of many disenchanted views. Making a comparison that old people who are on their way out anyway are responsible for rising health care costs. Gorman then becomes almost offensive when he suggests some AIDS patients deserve their predicament and others don't. At this point, the reader sees that Gorman is being very sarcastic and bitter towards physicians who mare share this view. In paragraph three, Gorman attempts to make an analogy between other professions and related obligations. In essence, the analogy equates the amount of money and personal taste one may have, with the level of care and/or attention one deserves. The analogy appears to be very inappropriate at first. However, this may be exactly what Gorman is trying to point out, making the reader more sympathetic to the thesis.
Gorman begins to touch on a sound idea of preventative medicine in paragraph four where he writes... the medical profession is finally beginning to see that patients have a responsibility for their own health. The credibility of the previous statement is destroyed when Gorman goes on to make a false analogy, comparing doctors with small business, and suggests that there is no difference between the two fields. Gorman suggest that, like in small business, doctors should eliminate the riffraff in their establishments. Unfortunately, the definition of riffraff is never revealed. Gorman goes on further to suggest which diseases or ailments should not be treated without any reason except personal bias. The sarcastic tone is turned up a notch on the proverbial dial from ten to eleven.
Making a hasty generalization would usually destroy credibility on an issue, but used with the tone and thesis of this essay, it actually supports Gorman's point. Gorman specifies carpal tunnel syndrome as a deserved ailment. In the last sentence of paragraph five, Gorman writes that carpal tunnel syndrome in people who write a lot of trash about ethics and responsibility. With this Post Hoc, Gorman is successful in revealing a hidden truth. Gorman is suggesting that some physicians feel they need not acknowledge ethics and responsibilities associated with their position. Willfully presenting it with such a tone the reader will not and cannot sympathize with the writer. Again, further supporting the thesis.
Towards the end of the essay, Gorman has ruled out so many possible candidates for treatment, the physicians themselves will be left with little clientele. The argument is so ridiculous, it turns full circle and defeats itself. In Gorman's conclusion it is self-evident what's being said is that medicine is not just a business and cannot be treated as if it were. It is much more than nine to five and making a buck. Unfortunately some physicians may have forgotten this for the moment. Stockbrokers are not required to take a Hippocratic Oath, and are therefore not bound to the same ethical responsibilities as physicians. The essay did not follow a classical structure, but was none the less effective. Rhetorical comments and questions were abundant and the conclusion was cleverly used as a concession. Who needs structure in an essay? Really. How dumb can you get?