A Behavioral and Systems View of Professionalism

被引:172
作者
Lesser, Cara S. [1 ]
Lucey, Catherine R. [2 ]
Egener, Barry [3 ]
Braddock, Clarence H., III [4 ]
Linas, Stuart L. [5 ]
Levinson, Wendy [6 ]
机构
[1] Amer Board Internal Med Fdn, Fdn Programs, Philadelphia, PA USA
[2] Ohio State Univ, Coll Med, Columbus, OH 43210 USA
[3] Fdn Med Excellence, Portland, OR USA
[4] Stanford Univ, Palo Alto, CA 94304 USA
[5] Univ Colorado, Denver Sch Med, Dept Med, Denver, CO 80202 USA
[6] Univ Toronto, Dept Med, Toronto, ON, Canada
来源
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION | 2010年 / 304卷 / 24期
关键词
PERFORMANCE; MEDICINE;
D O I
10.1001/jama.2010.1864
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Professionalism may not be sufficient to drive the profound and far-reaching changes needed in the US health care system, but without it, the health care enterprise is lost. Formal statements defining professionalism have been abstract and principle based, without a clear description of what professional behaviors look like in practice. This article proposes a behavioral and systems view of professionalism that provides a practical approach for physicians and the organizations in which they work. A more behaviorally oriented definition makes the pursuit of professionalism in daily practice more accessible and attainable. Professionalism needs to evolve from being conceptualized as an innate character trait or virtue to sophisticated competencies that can and must be taught and refined over a lifetime of practice. Furthermore, professional behaviors are profoundly influenced by the organizational and environmental context of contemporary medical practice, and these external forces need to be harnessed to support-not inhibit-professionalism in practice. This perspective on professionalism provides an opportunity to improve the delivery of health care through education and system-level reform. JAMA. 2010;304(24):2732-2737 www.jama.com
引用
收藏
页码:2732 / 2737
页数:6
相关论文
共 18 条
[1]   Professionalism in medicine: Results of a national survey of physicians [J].
Campbell, Eric G. ;
Regan, Susan ;
Gruen, Russell L. ;
Ferris, Timothy G. ;
Rao, Sowmya R. ;
Cleary, Paul D. ;
Blumenthal, David .
ANNALS OF INTERNAL MEDICINE, 2007, 147 (11) :795-U60
[2]   Alliance between society and medicine - The public's stake in medical professionalism [J].
Cohen, Jordan J. ;
Cruess, Sylvia ;
Davidson, Christopher .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2007, 298 (06) :670-673
[3]  
Durant W., 1991, The story of philosophy: The lives and opinions of the world's greatest philosophers
[4]  
FREIDSON Eliot., 2001, PROFESSIONALISM 3 LO
[5]   Systematic review: The evidence that publishing patient care performance data improves quality of care [J].
Fung, Constance H. ;
Lim, Yee-Wei ;
Mattke, Soeren ;
Damberg, Cheryl ;
Shekelle, Paul G. .
ANNALS OF INTERNAL MEDICINE, 2008, 148 (02) :111-123
[6]   Context, conflict, and resolution: A new conceptual framework for evaluating professionalism [J].
Ginsburg, S ;
Regehr, G ;
Hatala, R ;
McNaughton, N ;
Frohna, A ;
Hodges, B ;
Lingard, L ;
Stern, D .
ACADEMIC MEDICINE, 2000, 75 (10) :S6-S11
[7]   Physician-citizens - Public roles and professional obligations [J].
Gruen, RL ;
Pearson, SD ;
Brennan, TA .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2004, 291 (01) :94-98
[8]   The Increasing Complexities of Professionalism [J].
Hafferty, Frederic W. ;
Castellani, Brian .
ACADEMIC MEDICINE, 2010, 85 (02) :288-301
[9]   Arrow on trust [J].
Hall, MA .
JOURNAL OF HEALTH POLITICS POLICY AND LAW, 2001, 26 (05) :1131-1144
[10]   What can we say about the impact of public reporting? inconsistent execution yields variable results [J].
Hibbard, Judith H. .
ANNALS OF INTERNAL MEDICINE, 2008, 148 (02) :160-161