By Dennis H. Novack, MD, Professor of Medicine and Associate Dean of Medical Education at Drexel University College of Medicine, and Editor at Health Care Communication and Professional Formation
Hippocrates observed, “the patient, though conscious that his condition is perilous, may recover his health simply through his contentment with the goodness of the physician.” This goodness almost certainly included many of the qualities that we now recognize as components of medical professionalism. Physician goodness has enabled the medical profession to survive and thrive for millennia until recently.
The ethical commitments, values, compassion, and communication skills that comprise physicians’ bedside manner have been eclipsed by the incredible progress of biomedicine. Encouraged by this progress, medical training focused mainly on diagnosis and treatment, and patients were often considered the battleground on which doctors and diseases fought. In the mid-1970s, George Engel, MD, articulated the biopsychosocial model, which has been widely adopted in medical training. Students and trainees have been increasingly taught communication skills including expressions of empathy, delivering bad news, and behavioral techniques to enhance patients’ understanding of and adherence to care plans, among others. This emphasis on community health, disparities in care, humanism, and medical ethics have brought greater clarity to patient and community needs and perspectives, ethical principles of the primacy of patient welfare, respect for patient autonomy, and more recently social justice in care.
For the past 25 years, medical education leadership has recognized the need to define, promote, and assess medical professionalism. Medical education and practice leadership organizations have issued statements promoting professionalism, noting that myriad changes in the health care environment have contributed to a drastic erosion of patient trust in health care providers and the health care system. Among them are changes in health care delivery, the corporatization and financialization of health care, a perceived emphasis on quantity over quality of care, high levels of burnout among health professionals, publicity about medical errors, failures to self-regulate our professions and individual practitioners, and the spreading of misinformation via the internet and social media.
In March of 2024, the American Board of Medical Specialties (ABMS) leadership issued a Position Statement on Promoting Professionalism. It states “…that professionalism is grounded in the social contract between medicine and society. Physicians are afforded autonomy, self-regulation, and financial and non-financial rewards that are tied to the expectation that they will be devoted to the public good, be trustworthy, and maintain competence in their profession. Professionalism is a shared commitment that pledges a dynamic process of personal development, life-long learning, and professional formation predicated on participation in a social enterprise that continuously seeks to express expertise and caring in its work.” The statement further clarifies that the “…ABMS defines professionalism as a belief system that serves as both a moral compass and operational framework for the organization and delivery of medical care.”
How well have the ABMS Member Boards responded to this challenge? Articles in this issue highlight some of the advances that the boards are making, but there is clearly more to do, especially given the emerging research in this area. For example, there is now a body of research demonstrating the relationships between greater professionalism and patient safety, adherence to care plans, reduced medical errors, and enhanced teamwork and collaboration, as well as increased patient trust and satisfaction. ABMS and the boards could encourage the Accreditation Council for Graduate Medical Education to create and implement standards for faculty development and dedicate real time to a curriculum in professionalism. The boards could implement periodic assessments of individual and team professionalism and collaboration; measure and create structures that ensure a respectful, inclusive, and optimal learning culture; measure fellow and staff satisfaction and levels of burnout; and create programs to minimize and address burnout. The boards could promulgate best practices and expectations of hospital leadership. There has been a burgeoning of literature on effective leadership styles that promote a continuous improvement culture, staff engagement, creativity, productivity, and a trustworthy atmosphere that enhances employees’ happiness at work and improves job performance and motivation. Leaders can intentionally work to foster staff’s self-worth, feelings of inclusion, trust, and psychological safety, all of which have been shown to encourage the formal reporting of medical errors and learning from mistakes.
As the Immediate Past President of the Academy for Professionalism in Health Care, I know our members would welcome offers of collaboration with individual boards to enhance their efforts in the promotion and assessment of professionalism. We look forward to when the critical efforts in medical professionalism of ABMS and its Member Boards have optimized provider effectiveness and satisfaction, enhanced patient care, and restored patient trust.
“For the past 25 years, medical education leadership has recognized the need to define, promote, and assess medical professionalism.”
© 2025 American Board of Medical Specialties
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