A covenant can generally be defined as an agreement that yields a relationship of commitment between two parties. Such a commitment once existed between physicians and society. Physicians, by sacrificing their 20’s (and in some cases, a good portion of their 30’s) and dedicating themselves to become proficient in the healing arts, would be granted by society a better than average living, an independent career and a place of respect in their community. This agreement, steadfast for years, has recently been abrogated by society; in the 1990’s with the advent of managed care and most recently, with the Affordable Care Act. So while physicians must still sacrifice their youth to learn the healing arts, society has capped their salaries, diminished their status in society and curtailed their independence.
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