Professionalism in medicine: results of a national survey of physicians.
BACKGROUND
The prospect of improving care through increasing professionalism has been gaining momentum among physician organizations. Although there have been efforts to define and promote professionalism, few data are available on physician attitudes toward and conformance with professional norms.


OBJECTIVE
To ascertain the extent to which practicing physicians agree with and act consistently with norms of professionalism.


METHODS
National survey using a stratified random sample.


METHODS
Medical care in the United States.


METHODS
3504 practicing physicians in internal medicine, family practice, pediatrics, surgery, anesthesiology, and cardiology.


METHODS
Attitudes and behaviors were assessed by using indicators for each domain of professionalism developed by the American College of Physicians and the American Board of Internal Medicine. Of the eligible sampled physicians, 1662 responded, yielding a 58% weighted response rate (adjusting for noneligible physicians).


RESULTS
Ninety percent or more of the respondents agreed with specific statements about principles of fair distribution of finite resources, improving access to and quality of care, managing conflicts of interest, and professional self-regulation. Twenty-four percent disagreed that periodic recertification was desirable. Physician behavior did not always reflect the standards they endorsed. For example, although 96% of respondents agreed that physicians should report impaired or incompetent colleagues to relevant authorities, 45% of respondents who encountered such colleagues had not reported them.


CONCLUSIONS
Our measures of behavior did not capture all activities that may reflect on the norms in question. Furthermore, behaviors were self-reported, and the results may not be generalizable to physicians in specialties not included in the study.


CONCLUSIONS
Physicians agreed with standards of professional behavior promulgated by professional societies. Reported behavior, however, did not always conform to those norms.
Massachusetts General Hospital, Institute for Health Policy, Boston, Massachusetts 02114, USA. ecampbell@partners.org
Eric G
EG
Campbell
Susan
S
Regan
Russell L
RL
Gruen
Timothy G
TG
Ferris
Sowmya R
SR
Rao
Paul D
PD
Cleary
David
D
Blumenthal
D001291:Attitude of Health Personnel; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D010820:Physicians / Q000592:standards*; D010818:Practice Patterns, Physicians' / Q000592:standards; D011364:Professional Practice / Q000592:standards*; D011787:Quality of Health Care; D011795:Surveys and Questionnaires; D014481:United States