Foundation Programs, American Board of Internal Medicine Foundation, Philadelphia, Pennsylvania, USA.
JAMA. 2010 Dec 22;304(24):2732-7. doi: 10.1001/jama.2010.1864.
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.
职业道德或许不足以推动美国医疗体系发生深刻而深远的变革，但如果没有职业道德，医疗事业就会迷失方向。定义职业道德的正式声明一直是抽象的和基于原则的，没有清楚地描述专业行为在实践中是什么样子。本文提出了一种职业道德的行为和系统观点，为医生及其所在组织提供了一种实用方法。更注重行为的定义使得在日常实践中追求职业道德更加可行和可实现。职业道德需要从被概念化为一种内在的性格特征或美德，演变为可以而且必须在一生的实践中教授和完善的复杂能力。此外，专业行为受到当代医疗实践的组织和环境背景的深刻影响，这些外部力量需要被利用来支持——而不是抑制——实践中的职业道德。这种职业道德观为通过教育和系统层面的改革来改善医疗服务提供了机会。
