[The social meaning of medical professionalism]

This essay looks into the meaning of today's professionalism and the apparent inconsistency between its growing status and a context of profound changes and dissatisfaction with medical practice. The cultural climate of our times is reviewed, as the framework for understanding changes in the social organization of medicine. One of the critical traits of professions has been their power to manage specialized knowledge under their own standards, without external control. The limits of this self regulation of expertise have faded, representing an important threat for professionalism. Together with the fundamental changes and tensions of work conditions for professionals, however, the appeal of professionalism is on the rise. Because of its ability to submit devastating individualism to collective interests, professionalism can contribute to the stability of social systems, as a third logic, between the market and public organizations. In medicine, professionalism as a value based system and ideology, also emerges as a response to the challenges posed to its practice. It represents reflection and preservation of traditional values inspiring a practice of excellence, which will undoubtedly restore and enhance public confidence in medicine.