title: Developing the "why" facet of medical professionalism.
abstract: Numerous articles have been published that discuss medical professionalism from the perspective of "what-to-be" and "what-to-do". In this paradigm, for doctors to effectively execute the "right" attitudes and behaviors, they must incorporate a "know-how" attitude or "reflective practice" into their professional lives. However, definitions of "what" change over time in an evolving social context. For physicians to be able to continue incorporating the right new attitudes and behaviors, they must also develop a "know-why" perspective. The health care market follows the criteria of a "market for lemons". The high degree of information asymmetry seen in health care is a strong risk factor for adverse selection, producing an excess of defective articles of commerce in the market. In this case, the processes of signaling and screening, two known solutions for adverse selection in general, cannot bridge the information gap between patients and doctors, since patients must put their lives and their privacy into doctors' hands. Professionalism, therefore, is used by doctors to win the trust of patients, their caregivers and society at large. This is the "why"-level intellect, in which the physician sets developing public trust as a goal for his own self-actualization and develops it in conjunction with altruism. This is a key to success for the physician as a doctor and as a person.
authors.affiliation: Division of General Internal Medicine, Department of Medicine, Kanazawa University Hospital, Ishikawa, Japan. hnomura@med.kanazawa-u.ac.jp
authors.forename: Hideki
authors.initials: H
authors.lastname: Nomura
mesh_terms: D004501:Education, Medical; D006801:Humans; D010819:Physician's Role; D010817:Physician-Patient Relations; D011364:Professional Practice; D035502:Trust