Research and Policy Recommendations

Medical Professionalism

The concept of medical professionalism has evolved substantially over the recent century. In the 1960s and 1970s, many commentators equated professionalism with the preservation of guild-like monopolies whose essential purpose was to restrict entrance and protect the interests of practitioners. In the 1990s, in the aftermath of the rise of managed care, professionalism assumed a very different meaning. Both physicians and consumers invoked its principles to defend their prerogatives and to protest the restrictions on service delivery imposed by health maintenance organizations. Alert to this record, the Division of Social Medicine and Professionalism maintains that the principles of professionalism have a vital role to play in the health care system.

Four key values underlie medical professionalism.

• Altruism and Commitment to Patients’ Interests. As changing market forces continue to confront the medical profession, physicians are increasingly challenged to maintain an unwavering commitment to their patients.
• Physician Self-Regulation. Group pressures not to report a colleague or indifference to the performance of others might lead doctors to ignore a colleague’s ineptitude or malfeasance, compromising patients’ health and safety.
• Maintenance of Technical Competence. The pace of innovation in medicine is unprecedented. Absent a commitment to life-long learning, the knowledge base of the best trained physician will soon be outmoded and fall short of best medical practice.
• Civic Engagement. Physicians should enlarge the scope of their concerns from the well-being of an individual patient to a concern for the welfare of all patients. They must make their voices heard by communicating their knowledge to the public.