“You are in this profession as a calling, not a business; as a calling which exacts from you at every turn self-sacrifice, devotion, love and tenderness to your fellow men. Once you get down to a purely business level, your influence is gone, and the true light of your life is dimmed” — Sir William Osler (1849–1919)
Few figures in modern medicine command as much reverence and respect as Sir William Osler. Canadian by birth, he was one of the founders of Johns Hopkins Hospital in the US and later Regius Professor of Medicine at Oxford, England. Described as the ‘father of modern medicine’, Osler combined scientific rigour with deep humanism in medicine. More than a century after his death, his teachings remain highly relevant for physicians navigating the technological complexities of contemporary medicine.
Osler believed that medicine was not merely a technical profession but a calling — a lifelong moral commitment to humanity rather than a simple business or trade. He emphasised compassion, humility, lifelong learning, bedside teaching and the importance of treating the patient rather than merely the disease. His famous aphorism, “The good physician treats the disease; the great physician treats the patient who has the disease”, captures his philosophy of medicine, at the heart of which was the doctor-patient relationship. He viewed medicine as profoundly personal, anchored in empathy, listening and human connection. Clinical competence alone was insufficient; the physician also needed character, compassion and integrity. He believed medicine was fundamentally a service profession, not merely a business, and the physician’s primary duty, above all else, was the patient’s welfare, not financial gain.
Osler, of course, practised in a very different era, but his ethical philosophy challenges the commercialisation of medicine we see today. This does not mean physicians should not be fairly compensated. Rather, it raises deeper questions about healthcare that today is governed primarily by market forces. Hospitals function like corporations and efficiency, profitability, and competition have overshadowed empathy, equity and ethical responsibility. Terms such as ‘volumes’, ‘targets’, ‘packages’, ‘profits’ and ‘discounts’ have found their way into the healthcare lexicon, replacing ‘ethics’, ‘morality’, ‘dignity’, ‘compassion’, ‘empathy’, ‘trust’ — terms once associated with the medical profession.
What would Osler say about medical practice in Pakistan today, where a flourishing private medical sector coexists with a chronically underfunded and poorly organised public health system? In overcrowded government hospitals, accessed by the poorest of society, physicians face huge patient volumes, limited resources and systemic corruption. Consultations may last only a few minutes and staff struggle to provide individualised care.
At the other end of the spectrum, private healthcare in Pakistan increasingly reflects market-driven models of care, unaffordable to the vast majority. Quality care depends on one’s ability to pay. For millions of Pakistanis, catastrophic out-of-pocket expenditures push families into debt or force them to forgo treatment altogether. In the absence of an effective universal public health system, private healthcare has become a billion-dollar industry and the major provider of care, particularly in cities. Osler’s philosophy would urge us to ask not only how healthcare is delivered, but for whom?
Pakistan’s health challenges today remain deeply connected to social determinants: poverty, malnutrition, poor sanitation, environmental degradation, low literacy and gender inequality. Health problems such as tuberculosis, dengue fever, diarrhoeal illnesses, infant and maternal mortality cannot be addressed through clinical medicine alone. Preventive medicine and health promotion are non-existent. The country’s public health infrastructure remains fragmented and underfunded. Osler understood the importance of broader social conditions in shaping health, as he worked in a period when infectious diseases, poverty, sanitation and public health reforms were central concerns — ironically, conditions that were not very different from what we find in Pakistan today!
Osler reminds us that medicine cannot be separated from social responsibility. He believed physicians should engage not only with individual patients but with the broader conditions affecting community well-being. They should not confine themselves to narrow technical roles but actively engage with questions of equity, access and public welfare. Physicians occupy positions of significant social trust and influence, and they must use their influence to advocate for fair health policies and social justice. They must advocate for stronger public health systems, equitable healthcare financing, preventive care and universal access to healthcare. Few physicians in Pakistan commit themselves to these roles.
Osler also exemplified a model of ethical leadership based on professionalism, integrity and service above status, prestige or financial gain. In Pakistan, where healthcare governance is often affected by political instability, resource disparities, institutional weaknesses and endemic corruption, ethical medical leadership is critically important.
William Osler transformed medicine by insisting that scientific excellence and human compassion were inseparable. He revolutionised medical education by shifting it out of the traditional lecture hall and into the hospital wards, pioneering the bedside clerkship model and the residency training system, requiring students and young doctors to learn through direct, hands-on patient care and observation, which is practised today. He said, “Medicine is learned by the bedside and not in the classroom.”
His teachings continue to resonate because they directly address conflicts at the very heart of the medical profession — the importance of scientific progress versus medicine as an art, grounded in human understanding. He reminds us that medicine cannot simply be a marketplace commodity or a technical enterprise disconnected from social realities.
Ultimately, Osler believed that medicine was about caring for human beings, in all their vulnerability and dignity. In today’s age of blatant commercialisation and commodification, rising costs of healthcare, social injustice, inequality, and technological complexity, that vision is not nostalgic but urgently necessary.
The writer is professor emeritus, psychiatry, Aga Khan University.
Published in Dawn, July 12th, 2026