Renewing professionalism: an opportunity for medicine

In recent decades, both the concept and the performance of professionals have been widely questioned. Professionalism and the idea of service have been placed under intense pressure, but they have survived. Medicine may now have an opportunity to reestablish itself as a respected, influential, and useful profession in Western society. The authors believe this could occur (1) because of the strength of the democratic process and the place of organized medicine within it; (2) because medicine's role as a source of relatively impartial expertise is being reestablished (because medicine no longer controls the health care system); and (3), most important, because of the importance of the individual physician as healer in both society's view of medicine and medicine's view of itself. To take advantage of this opportunity, the authors offer several recommendations, including (1) that medicine must continue current efforts to place first the doctor-patient relationship (the role of the healer) and the idea of service in redefining and fulfilling its obligations to society; (2) that there be a comprehensive education campaign to help physicians understand professionalism and its obligations (which the authors define); and (3) that physicians should assume responsibility for their local and national associations. If the individual medical professional and all the institutions connected with the practice and teaching of medicine truly understand and seek to fulfill their contracts with society and the obligations derived from these, the morality inherent in medical professionalism can be a dominant force, and better health care will result.