Medical Professionalism Needs Recommitment

Physicians need to recommit themselves to the "fundamentals" of medical professionalism due to "widespread threats" to that professionalism, said Jock Murray, MD, keynote speaker at the American College of Physicians opening session here Thursday. Dr. Murray also called for revising medical school admission criteria to ensure that future doctors are not just intellectually talented but are the kind of people who value medical professionalism. The fundamentals of medical professionalism - competence, the primacy of patient welfare, and social justice - have been eroding, said Dr. Murray, professor emeritus, Dalhousie University, Halifax, Nova Scotia, Canada. Physicians must stand up for their values and seek common ground with the groups - business, law, military, and government - that have been the primary forces behind the erosion, he said.

"The groups that would like to alter and undermine professionalism are not bad people - they just have a different professional and ethical system." The pressure from business interests is the greatest, noted Murray. "There is increasing desire by other parties to have physicians function as skilled employees rather than professionals."

Physicians also have the challenge of maintaining their public image, which has eroded along with the actual decline in professionalism, Murray said. The popular perception of doctors is now powerfully influenced by television shows that often portray physicians negatively, he said. Shows such as House and Nip and Tuck portray physicians as money-driven, moody, rude, disrespectful, selfish and cynical, he said.