Medical Professionalism in the New Millenium: A Physician Charter

Physicians today face challenges to maintaining a high level of medical professionalism, and must reaffirm their commitment to the principles of professionalism: patient welfare, patient autonomy, and social justice.

Context, Conflict, and Resolution: A New Conceptual Framework for Evaluating Professionalism

The current methods of evaluating professionalism in physicians and medical students tend to focus on characteristics of the individual.  Medical professionals should shift their evaluation to a more behavioral-based approach, which should include consideration of the particular context and conflict of each case.  Additionally, peer- and self-assessment, as well as an understanding of what causes students to lapse into unprofessional behavior, should be included in evaluating professionalism.

Culturally Competent Health Care

This article addresses the ways in which culturally competent health care can be implemented, at the individual, system, and managed care levels.

Development of a Physician Attributes Database as a Resource for Medical Education, Professionalism and Student Evaluation

In the light of the growing interest in professionalism and non-cognitive attributes in medical education, a focus group methodology was used to achieve a database of desired physician attributes.  Among the attributes appearing with the highest frequency were: honest, empathic, patient, capacity to be an attentive listener, understanding, able to work in a team.  This database is multipotential and preliminary in nature and requires further processing before achieving full relevance.

Do Doctors Have a Future?

The author discusses the continued efforts of the Royal College of Physicians (UK) to develop a heightened awareness of medical professionalism within its ranks.  It also highlights the challenges to making professionalism relevant and accessible to physicians.

Medical Professionalism in Society

Health care motivated by markets and government have posed a threat to the integrity of medical professionalism.  A social model of professionalism should encompass these three traits: devotion to medical service, public profession of values, and negotiation regarding professional values and other social values.  Physicians should routinely advocate for their patients' interests, while taking care to establish a solid moral foundation for their dissent if made public. 

Medical Professionalism: Focusing on the Real Issues

Medical professionalism needs to be recreated, as self-regulation, conflicts of interests, and enforcement of professional standards have deteriorated.  Solutions, such as applying professionalim in medical school curriculum and encouraging organized medicine to protect whistle blowers, are necessary to ensure that professionalism be put to practice. 

Medical Professionalism: More than Simply a Job

Physician behavior occassionally falls short of professional behavior including altruism, compassion, service, accountability, respect and life-long learning.  Physicians should create a learning environment that reinforces professional behavior and addresses negative behavior through rewards and modeling. 

Medicine as a Profession: Back to Basics

Medical professionalism requires the preservation and existence of the doctor-patient relationship.  A strong relationship may prevent future problems and is essential for top quality care.  The physician-patient relationship is threatened by lack of access to ongoing care and changes in insurance coverage.  Often the nature of medical practice undermines continuity of care.  Physicians must address problems of access to health care and limited funding for primary care.  Furthermore, it is essential to cherish effective, stable doctor-patient relationships.

Medicine: The Prosperity of Virtue

Medical regulation in Great Britain has swung too far in favor of tightly enforced rules that result in a culture of suspicion about doctors.  This punitive system must be balanced with an emphasis on a doctor's natural desire to promote positive patient outcomes compassionately, altruistically, and scientifically.  The author promotes teamwork, education, appraisal, and research on professionalism as four ways to achieve this goal.

Professionalism for Medicine: Opportunities and Obligations

Physicians, as professionals, must adhere to a social contract between themselves and society.  As professionalism has come under attack by society, physicians must repossess the tenets of professionalism as their own, committing themselves to proper self-regulation, integrity, altruism, and competence. 

Professionalism: An Ideal to Be Sustained

Medical professionalism bridges the gap between society and physicians, and is the source of patient trust and the privileges granted to health professionals.  Professionalism serves as a contract between society and medicine.  Its core elements are specialized knowledge and a commitment to serving others.  Society assumes that professionals act altruistically at all times, and this trust must be confirmed by its perception of physicians' ability to meet this obligation. However, professionalism is being redefined in response to changes in health care and medicine's sometimes egregious failure to self regulate. Society no longer has faith in physicians upholding the contract, and changes are required.  This article traces professionalism's role, nature, evolution and future.

Reframing the Professional Ethic: The Council of Medical Specialty Societies Consensus Statement on the Ethic of Medicine

The American Medical Association's Code of Medical Ethics focuses on the physician-patient relationship, on the individual level.  This code, however, does not address more global issues, such as universal access to health care.  The CMSS code, written by and for physicians, calls for physicians' committment to both their individual patients and society at large.  Furthermore, all physicians, both clinical and non-clinical, should focus first on their patients.   

Renewing Professionalism: An Opportunity for Medicine

The concept of professionalism has been under much strain recently.  However, the authors argue, medicine has the potential now to reinvent itself as a profession with integrity, because, among other reasons, society takes the physician's role as healer very seriously.  The authors suggest putting the doctor-patient relationship first, taking responsibility for professional associations, and educating those in the field on professionalism as ways in which to restore professionalism. 

The Patient As A Policy Factor: Consumer/Survivor Movement In Mental Health

The article explores the history of the modern consumer/survivor movement in Psychiatry.  It looks at the impact of these movements both on policy and on the effect on the field of Psychiatry.

Toward a Normative Definition of Medical Professionalism

The author identifies nine behaviors that constitute medical professionalism: ("Physicians subordinate their own interests to the interests of others; Physicians adhere to high ethical and moral standards; Physicians respond to societal needs, and their behaviors reflect a social contract with the communities served; Physicians evince core humanistic values, including honesty and integrity, caring and compassion, altruism and empathy, respect for others, and trustworthiness; Physicians exercise accountability for themselves and for their colleagues; Physicians demonstrate a continuing commitment to excellence; Physicians exhibit a commitment to scholarship and to advancing their field; Physicians deal with high levels of complexity and uncertainty; Physicians reflect upon their actions and decisions."

What Is Accountability in Health Care?

This article outlines the parameters of accountability in health care.  It sheds light on the various methods that institutions use to keep track of activities and procedures for evaluating.  Different models per sector of accountability are delineated.