Medical Professionalism A Closer Look at the American Board of Internal Medicine’s Physician Charter

What is Medical Professionalism? Basis of medicine’s contract with society Prompts a thorough examination of underlying causes of illness Places interests of patients above those of physician, provides expert advice on health to society, and maintains standards of competence and integrity Many challenges impede medical professionalism http://physiciansforhumanrights.org

Fundamental Principles of ABIM Physician Charter Principle of primacy of patient welfare to provide patient-centered care Principle of patient autonomy in which physicians must be honest with their patients Principle of social justice to eliminate discrimination in health care

Professional Responsibilities of ABIM Physician Charter 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

Human Rights Basis for Professionalism in Health Care Improve patient care by enhancing cultural competency, recognizing root causes of disease, and helping people stay healthier longer Build community health to provide accessible, affordable, and quality care Enhance health policy by using human rights to advocate for closing of racial disparities

AAAQ Framework Availability- health facilities, goods, and services must be available in sufficient quantity Accessibility- health services must be accessible to everyone without discrimination Acceptability- health services must be respectful of medical ethics, culturally appropriate and gender sensitive Quality- health services must be scientifically and medically appropriate and of good quality

Environmental Forces that Affect Physician Behavior Payment policy- health care services are compensated at different levels and physicians may be inclined to use more or less services Organizational strategies- need for a renewed focus on mission and culture change, an electronic health record, and a performance measurement system Public performance- encouraged to embrace public reporting that supports continuous quality improvement in practice