Professionalism reconsidered. Priorities for physicians.
F EW PHYSICIANS today believe that they are prac t i c ing in the “golden age” of medicine. Comprehensive social, technological, political, and economic changes challenge their adaptive resources. They also confront the forces of bureaucratization and corporatization that pressure them to subordinate their professional autonomy and control to other systems, and, in some cases, to place corporate benefit above professional values. Furthermore, many believe that the medical profession faces an internal crisis of moral standing and authority. Medicine’s prestige has diminished, and despite potentially offering more to society than ever before in history, its role and conduct are openly criticized. Some critics even question whether medicine has lost its status as a profession. How should physicians respond? We have several options: (1) we can do nothing and let evolving social forces create our future; (2) we can react confrontationally and seek our own best interests much like a trade or a union; or (3) we can try to restore society’s confidence by diligently, openly, and actively practicing professionalism. We can enlightenmedical students andresidents about what the term “profession” means. We can also inspire them with its potential for personal and public good by demonstrating its joys and obligations through our curricula and our professional role modeling. Practicing physicians can also consciously affirm their calling into medicine and they can commit themselves once again to the values and obligations that ground their professional character, commitment, and craftsmanship.