In a recent commentary (“Maine doctor uses cash model that worked since Hippocrates,” Oct. 4), M.D. Harmon expresses effusive praise for Dr. Michael Ciampi’s decision to convert his practice into a “cash model” and how it honors Hippocrates.

What Mr. Harmon fails to understand is that the spirit of the Hippocratic Oath for almost 2,500 years has bound physicians to care for all who come to the door of their practices.

However, this new “model” is clearly an exclusionary one, where what determines access to care is cash. Without it, the patient walks.

How humiliating can this be for the elderly on a limited income, who are told their Medicare is not good enough for them to be seen?

For the unemployed who are turned away? For children with chronic diseases whose only insurance is MaineCare? Mr. Harmon describes Dr. Ciampi’s family practice as a “purveyor of cash-on-the-barrelhead medicine” (yes, those are Mr. Harmons’s own admiring words), and he is certainly accurate: Medical care is reduced to a marketplace commodity and an entrepreneurial transaction.

Doctors who behave as such may be shrewd and prosperous businessmen, but such a deviation from the traditional “open door” practice of medicine speaks for itself.

We are fortunate, however, that most doctors continue to welcome all who seek care from them regardless of insurance or ability to pay, and by doing so truly honor the Hippocratic Oath they took when they were in medical school.

Nicholas Fowler is a resident of South Portland.

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