ABMS Professionalism Definition
Medical professionalism is a belief system in which group members (“professionals”) declare (“profess”) to each other and the public the shared competency standards and ethical values they promise to uphold in their work and what the public and individual patients can and should expect from medical professionals.
At the heart of these ongoing declarations is a three-part promise to acquire, maintain and advance: (1) an ethical value system grounded in the conviction that the medical profession exists to serve patients' and the public's interests, and not merely the self-interests of practitioners; (2) the knowledge and technical skills necessary for good medical practice; and (3) the interpersonal skills necessary to work together with patients, eliciting goals and values to direct the proper use of the profession's specialized knowledge and skills, sometimes referred to as the “art” of medicine. Medical professionalism, therefore, pledges its members to a dynamic process of personal development, life-long-learning and professional formation, including participation in a social enterprise that continually seeks to express expertise and caring in its work.
From this vantage point, medical professionalism functions as an ideology that declares an important role for its members in organizing and delivering health care in society. The standards governing professional work are articulated in various institutionalized forms, and in varying degrees of specificity, in documents such as codes, charters, competencies, and curriculae – with their content subject both to ongoing review and to improvement by the conjoint effort of members and the public. Core to both the profession’s technical expertise and its promise of service is the view that members, working together, are committed to maintaining the standards and values that govern their practice and to monitoring each others’ adherence to their standards on behalf of the public.
From within this framework, medical professionalism embraces a wide variety of behaviors, which can be articulated as specific competencies. Frequently articulated competencies include a commitment to carrying out professional responsibilities and an adherence to ethical principles; demonstration of compassion, integrity, and respect for others; responsiveness to patient needs that supersedes self-interest; respect for patient privacy and autonomy; accountability to patients, society and the profession; and sensitivity and responsiveness to a diverse patient population.
For medical professionalism to function effectively as a means of organizing and delivering health care, it must be recognized as an active and iterative process involving: (1) defining; (2) debating; (3) declaring; (4) distributing; and (5) enforcing the set of discrete, shared standards and values that medical professionals agree must govern its work. During this process, proposed definitions of competencies (whether technical, interpersonal, or values-based) are vetted through a process of internal debate. They then are declared to the public to open dialogue and to assure that they meet social needs while upholding core professional values. Subsequently, these standards must be distributed to all relevant stakeholders to ensure they are understood as the heart of medicine’s social contract with society, and they must be enforced as such by the profession. This entire process is underscored by a commitment to ongoing engagement with each other and with other stakeholders to develop and maintain consensus and to conjointly promote and enforce the agreed-upon competencies on behalf of patients and the public.
Developed by the Ethics and Professionalism Committee-ABMS Professionalism Work Group
Frederic W. Hafferty, MD, Maxine Papadakis, MD, William Sullivan, PhD, and Matthew K. Wynia, MD, MPH, FACP
Adopted: January 2012