PROFESSIONALISM

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• The words "profession" and "professional" come from the Latin word
"professio," which means a public declaration with the force of a
promise.
• Professions are groups which declare in a public way that their members
promise to act in certain ways and that the group and the society may
discipline those who fail to do so.
• The profession presents itself to society as a social benefit and society
accepts the profession, expecting it to serve some important social goal.
• The profession usually issues a code of ethics stating the standards by
which its members can be judged.

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• The marks of a profession are:
Competence in a specialized body of knowledge and skill
An acknowledgment of specific duties and responsibilities toward the
individuals it serves and toward society
The right to train, admit, discipline and dismiss its members for
failure to sustain competence or observe the duties and
responsibilities.

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The difference between a profession and a business
The line between a business and a profession is not entirely clear, since
professionals may engage in business and make a living by it.
However, one crucial difference distinguishes them: professionals have a
fiduciary duty toward those they serve. This means that professionals have a
particularly stringent duty to assure that their decisions and actions serve the
welfare of their patients or clients, even at some cost to themselves.
Professions have codes of ethics which specify the obligations arising from this
fiduciary duty.
 Ethical problems often occur when there appears to be a conflict between
these obligations or between fiduciary duties and personal goals.
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The recognized obligations and values of a professional physician
• Professionalism requires that the practitioner strive for excellence in the following areas, which should
be modeled by mentors and teachers and become part of the attitudes, behaviors, and skills integral to
patient care.
• These values should provide guidance for promoting professional behavior and for making difficult
ethical decisions.

Altruism: A physician is obligated to attend to the best interest of patients, rather than
self-interest.
Accountability: Physicians are accountable to their patients, to society on issues of public
health, and to their profession.
Excellence: Physicians are obligated to make a commitment to life-long learning.
Duty: A physician should be available and responsive when "on call," accepting a
commitment to service within the profession and the community.
Honor and integrity: Physicians should be committed to being fair, truthful and
straightforward in their interactions with patients and the profession.
Respect for others: A physician should demonstrate respect for patients and their 5
families, other physicians and team members, medical students, residents and fellows.
Compatibility of professionalism with the restrictions sometimes placed on
physician's judgments in managed care
 One of the principal attributes of professionalism is independent judgment about technical
matters relevant to the expertise of the profession.
 Today, many physicians work in managed care situations that require them to abide by policies
and rules regarding forms of treatment, time spent with patients, use of pharmaceuticals, etc.
 In principle, such restrictions should be designed to enhance and improve professional
judgment, not limit it.
 For example, requiring consultation is ethically obligatory in doubtful clinical situations;
penalizing consultation for financial reasons would be ethically wrong.
 Also, requiring physicians to adhere to practice guidelines and to consult outcome studies may
improve professional judgment; requiring blind adherence to those guidelines may be a barrier
to the exercise of professional judgment.
 The presence of rules, policies and guidelines in managed care settings requires the physicians
who work in these settings to make such judgments and to express their reasoned criticism of
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• MEDICAL PROFESSIONALISM IN THE NEW MILLENNIUM:
A PHYSICIAN CHARTER
USA
Comprise of
 3 fundamental principles
 10 Sets of Professional Responsibilities

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• Fundamental Principles
 Principle of primacy of patient welfare. The principle is based on a dedication to serving the
interest of the patient. Altruism contributes to the trust that is central to the physician-
patient relationship. Market forces, societal pressures, and administrative exigencies must
not compromise this principle.
 Principle of patient autonomy. Physicians must have respect for patient autonomy.
Physicians must be honest with their patients and empower them to make informed
decisions about their treatment. Patients’ decisions about their care must be paramount, as
long as those decisions are in keeping with ethical practice and do not lead to demands for
inappropriate care.
 Principle of social justice. The medical profession must promote justice in the health care
system, including the fair distribution of health care resources. Physicians should work
actively to eliminate discrimination in health care, whether based on race, gender,
socioeconomic status, ethnicity, religion, or any other social category.
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• A Set of Professional Responsibilities
Commitment to professional competence
Commitment to honesty with patients.
Commitment to patient confidentiality
Commitment to maintaining appropriate relations with patients
Commitment to improving quality of care
Commitment to improving access to care
Commitment to a just distribution of finite resources
Commitment to scientific knowledge
Commitment to maintaining trust by managing conflicts of interest.
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