Transforming medical professionalism to fit changing health needs.
BACKGROUND
The professional organization of medical work no longer reflects the changing health needs caused by the growing number of complex and chronically ill patients. Key stakeholders enforce coordination and remove power from the medical professions in order allow for these changes. However, it may also be necessary to initiate basic changes to way in which the medical professionals work in order to adapt to the changing health needs.


CONCLUSIONS
Medical leaders, supported by health policy makers, can consciously activate the self-regulatory capacity of medical professionalism in order to transform the medical profession and the related professional processes of care so that it can adapt to the changing health needs. In doing so, they would open up additional routes to the improvement of the health services system and to health improvement. This involves three consecutive steps: (1) defining and categorizing the health needs of the population; (2) reorganizing the specialty domains around the needs of population groups; (3) reorganizing the specialty domains by eliminating work that could be done by less educated personnel or by the patients themselves. We suggest seven strategies that are required in order to achieve this transformation.


CONCLUSIONS
Changing medical professionalism to fit the changing health needs will not be easy. It will need strong leadership. But, if the medical world does not embark on this endeavour, good doctoring will become merely a bureaucratic and/or marketing exercise that obscures the ultimate goal of medicine which is to optimize the health of both individuals and the entire population.
Department of Social Medicine, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands. t.plochg@amc.uva.nl
Thomas
T
Plochg
Niek S
NS
Klazinga
Barbara
B
Starfield
D004502:Education, Medical, Continuing / Q000379:methods*; D006282:Health Personnel / Q000193:education*; D006801:Humans; D007857:Leadership; D009936:Organizational Innovation; D010819:Physician's Role; D011361:Professional Competence; D011785:Quality Assurance, Health Care / Q000458:organization & administration*