Although many physicians have been using the internet for both clinical and social purposes for years, recently concerns have been raised regarding blurred boundaries of the profession as a whole. In both the news media and medical literature, physicians have noted there are unanswered questions in these areas, and that professional self-regulation is needed. This report discusses the ethical implications of physicians’ nonclinical use of the internet, including the use of social networking sites, blogs, and other means to post content (...) online. It does not address the clinical use of the internet, such as telemedicine, e-prescribing, online clinical consultations, health-related websites, use of electronic media for clinical collaboration, and e-mailing patients (some of which are already covered in the AMA’s Code of Medical Ethics). (shrink)

Residency training in the Netherlands is to be restructured over the coming years. To this end a general competence profile for medical specialists has been introduced. This profile is nearly the same as the Canadian CanMEDS 2000 model, which describes seven general areas of medical specialist competence, one of which is professionalism. In order to establish a training programme for residents and their instructors based on this competence, it is necessary to develop a vision that does justice to everyday medical (...) practice. The two most prevailing views of professionalism—as personal, or as a behavioural characteristic—fall short of this. Only when professionalism is understood as reflective professionalism does it encompass the fundamental contextuality of medical treatment. This means that the focus of training and assessment must be shifted to accountability for treatment. (shrink)

Professionalism, like common sense, remains a timeless ingredient in the ethically successful practice of medicine in the twenty-first century. Professional ideals are particularly relevant in times of economic and social upheaval, medicolegal crises, provider shortages, and global threats to the public health. The American Board of Internal Medicine specifies professionalism as “constituting those attitudes and behaviors that serve to maintain patient interest above physician self-interest.” Because of its transcendent nature, professionalism, like ethics, is also considered “a structurally stabilizing, morally protective (...) force in society.” Professions enjoy tremendous deference and autonomy in exchange for three unwritten but prerequisite promises: expert knowledge, self-regulation, and a fiduciary responsibility to place the needs of the client ahead of self-interest. Many educators suggest that professionalism includes additional characteristics such as honesty, altruism, temperance, commitment, integrity, and suspension of self-interest. However, there are large gaps in providing more user-friendly and operational models of professionalism to learners and evaluators at all levels of the academic hierarchy. (shrink)

The thirteen essays in Educating for Professionalism examine the often conflicting ethical, social, emotional, and intellectual messages that medical institutions send to students about what it means to be a doctor. Because this disconnection between what medical educators profess and what students experience is partly to blame for the current crisis in medical professionalism, the authors offer timely, reflective analyses of the work and opportunities facing medical education if doctors are to win public trust. In their drive to improve medical (...) professionalism within the world of academic medicine, editors Delese Wear and Janet Bickel have assembled thought-provoking essays that elucidate the many facets of teaching, valuing, and maintaining medical professionalism in the middle of the myriad challenges facing medicine at the dawn of the twenty-first century. The collection traces how the values of altruism and service can influence not only mission statements and admission policies but also the content of medical school ethics courses, student-led task forces, and mentoring programs, along with larger environmental issues in medical schools and the communities they serve. Contributors: Stanley Joel Reiser Jack Coulehan Peter C. Williams Frederic W. Hafferty Richard Martinez Judith Andre Jake Foglio Howard Brody Sheila Woods Sue Fosson Lois Margaret Nora Mary Anne C. Johnston Tana A. Grady-Weliky Cynthia N. Kettyle Edward M. Hundert Norma E. Wagoner Frederick A. Miller William D. Mellon Howard Waitzkin Donald Wasylenki Niall Byrne Barbara McRobb Edward J. Eckenfels Lucy Wolf Tuton Claudia H. Siegel Timothy B. Campbell. (shrink)