Ethics

Medicine considers what defines professionalism

Physicians take an oath to uphold ethical standards, but rapid changes in the health care system may have begun to blur lines across the practice of medicine. What measures should physicians be held accountable to, and who should regulate the profession?

The May 12 issue of JAMA takes a deep dive into professionalism, including Viewpoints from scholars and academic leaders about the responsibility and accountability of medicine to self-govern, self-regulate and ensure the highest degree of professionalism.

Prominent physicians among the authors include AMA Executive Vice President and CEO James L. Madara, MD; Ezekiel J. Emanuel, MD, vice provost for global initiatives and chair of the department of medical ethics and health policy at the University of Pennsylvania; Thomas J. Nasca, MD, CEO of the Accreditation Council for Graduate Medical Education; and Lois Margaret Nora, MD, president and CEO of the American Board of Medical Specialties.

The issue examines the key roles and responsibilities of modern governing and accrediting bodies and of professional organizations and societies. Find out what these entities are doing—and what they should do differently—to enhance self-governance, safeguard self-regulation and foster professionalism.

Instilling professionalism

Where does the foundation for professionalism begin? According to one JAMA Viewpoint, it’s laid before medical school, and undergraduate medical education reinforces the commitment to professionalism. This piece holds that developing competence in professionalism is a core expectation for a physician learner, the same as developing competence in medical knowledge.

On a related note, this month’s issue of the AMA Journal of Ethics tackles this topic. The issue examines where professional boundaries start and stop, and how far physicians may go to assist patients with nonclinical matters.

Earn continuing medical education credit and investigate professional boundaries further by using a module from the AMA’s Council on Ethical and Judicial Affairs. Learn about key areas where establishing boundaries with patients may be challenging and issues outside the patient-physician relationship where boundaries are essential.

Continuous learning and self-regulation

Professionalism and lifelong learning go hand-in-hand, which gives way to professional self-regulation, according to another JAMA Viewpoint. Topics up for discussion include maintenance of certification and reforming the continuing medical education system.

With the increasing proportion of physicians employed by health care systems, what is the role of employers in governing and overseeing professionalism among physician-employees? Another JAMA Viewpoint explores how employment can advance or detract from professionalism goals.

Finally, the JAMA Viewpoint by Dr. Madara asks how physician and professional organizations can assist in professionalism. One way is to understand physicians’ intrinsic motivators and help craft environments that leverage these motivators. 

Read an editorial outlining all of these topic areas and view the list of 19 Viewpoints.