Journal List > Korean J Gastroenterol > v.65(3) > 1007346

Kim: Medical Professionalism — on Social Responsibilities Viewed from Historical Perspective


What is medical professionalism and does it matter to the patients? Medical professionals take responsibility for their judgements and the consequences that ensue. Traditionally medical professionalism is defined as a set of values, behaviors, and relationships which support the trust the public has in doctors. The public is well aware that absence of professionalism is harmful to their interests. However, the exercise of medical professionalism is endangered by the political and cultural environment. The values of professionalism have been changed throughout the medical history and the meaning of it was also changed according to social theories. Traditional medical professionalism was based on the virtue of autonomy, self-regulation and competency etc. However, in the new millenium era, the meaning of professionalism has changed under the concept of responsibility which includes the classical virtues. The meaning of professionalism nowadays is only based on the structure and conflicting theories which cannot solve all the issues surrounding professionalism in medical practice. The conditions of medical practice are critical determinants for the future of professionalism. The interaction between doctor and patient is central to the medical care, and medical professionalism has roots in almost every aspect of medical care. I argue that doctors have responsibility to act according to the values which have been determined by the medical profession, history and surrounding society. The new millennium medical professionalism which based on the responsibility could initiate a public dialogue about the role of the doctor in creating a fairer society.


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Table 1.
The Development of Medical Professionalism
Duration Development
13-14C The establishment of medical professionalism through the education in medieval universities
∼Late 18C The age of monopoly: the charted royal medical societies in European countries had the authority to punish the unregistered medical practitioners
18-19C The era of mercantilism and dissolution of monopoly of medieval guilds
Early 18C The Rose Case: the apothecary has the legal power to practice as the general practitioner in England
19C Professionalization of surgery and apothecary guilds in France
Late 19C The introduction of national medical insurance system in Germany
1960∼ The critiques to medical professionalism in the fields of sociology and philosophy
Mid 20C∼ The establishment of NHS in UK and the introduction of managed care in USA
Early 21C Medical professionalism in the new millennium: the introduction of the concept of responsibilities

C, century; NHS, National Health System.

Table 2.
Medical Professionalism in the New Millennium: A Physician
Fundamental principles
- Principle of primacy of patient welfare
- Principle of patient autonomy
- Principle of social justice
A set of professional responsibilities
- Commitment to professional competence
- Commitment to honesty with patients
- Commitment to patient confidentiality
- Commitment to maintaining appropriate relations with patients
- Commitment to improving quality of care
- Commitment to improving access to care
- Commitment to a just distribution of finite resources
- Commitment to scientific knowledge
- Commitment to maintaining trust by managing conflicts of interest
- Commitment to professional responsibilities
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