Concept of Professionalism

Society provides a profession with economic, political, and social rewards. Professions have specialized knowledge and the potential to maintain a monopoly on power and control, remaining relatively autonomous. A profession exists as long as it fulfills its responsibilities for the social good.

Today the activities of medical professionals are subject to explicit public rules of accountability. Governmental and other authorities at city, state, and federal levels grant limited autonomy to professional organizations and their membership thorough regulations, licensing requirement, and standards of service (e.g., Medicare, Medicaid, and the Food and Drug Administration). The Department of Health and Human Services regulates physician behavior in conducting research with the goal of protecting human subjects. The National Practitioner Data Bank, created in 1986, contains information about physicians and other health care practitioners who have been disciplined by a state licensing board, professional society, hospital, or health plan or named in medical malpractice judgments or settlements. Hospitals are required to review information in this data bank every 2 years as part of clinician recredentialing. There are accrediting agencies for medical schools, such as the Liaison Committee on Medical Education (LCME), and postgraduate training, such as the Accreditation Council for Graduate Medical Education (ACGME).

The public trust of physicians is based on the physician’s commitment to altruism, which is a cornerstone of the Hippocratic Oath, an important rite of passage and part of medical school commencement ceremonies. The core of professionalism is embedded in the daily healing work of the physician and encompasses the patient-physician relationship. Professionalism includes an appreciation for the cultural and religious/spiritual health beliefs of the patient, incorporating the ethical and moral values of the profession and the moral values of the patient. Unfortunately, the inappropriate actions of a few practicing physicians, physician investigators, and physicians in positions of power have created a societal demand to punish those involved and lead to the erosion of respect for the medical profession.