title: Systems model of physician professionalism in practice.
abstract: BACKGROUND
  This article proposes a systems level conceptualization of physician professionalism that is embedded in and results from the characteristics of the organizations in which doctors work such as hospitals, group practices and physician organizations.
  
  
  OBJECTIVE
  The goal of this study was to develop and test the systems model of professionalism.
  
  
  METHODS
  In total, 25 interviews were conducted in Minneapolis and Miami. Job titles of the subjects included hospital presidents, medical directors, chairs of hospital departments, quality and safety directors, chief of quality improvement and practising physicians. The data from the interviews were coded and then sorted by members of the study team into major and minor themes.
  
  
  RESULTS
  Virtually, all of the subjects were readily able to confirm aspects of the model by providing real-life examples of factors at the practice, hospital and market levels that they believed strongly influenced the extent to which physicians adhere, or fail to adhere, to the professional norms.
  
  
  CONCLUSIONS
  The systems model of professionalism was consistent with the views and experiences of physicians and administrators in two different geographic regions of the USA. If born out by further research, this model has implications for interventions aimed at improving professionalism as well as for professionalism as a field of study.
authors.affiliation: Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, MA, USA. bkitch@partners.org
authors.forename: Barrett T
authors.initials: BT
authors.lastname: Kitch
authors.forename: Catherine
authors.initials: C
authors.lastname: Desroches
authors.forename: Cara
authors.initials: C
authors.lastname: Lesser
authors.forename: Amy
authors.initials: A
authors.lastname: Cunningham
authors.forename: Eric G
authors.initials: EG
authors.lastname: Campbell
mesh_terms: D001291:Attitude of Health Personnel; D006123:Group Practice / Q000458:organization & administration; D006740:Hospital Administrators / Q000458:organization & administration; D006761:Hospitals; D006801:Humans; D008318:Malpractice / Q000331:legislation & jurisprudence; D008329:Managed Care Programs / Q000458:organization & administration; D015279:Organizational Culture; D010819:Physician's Role; D010820:Physicians / Q000592:standards*; D010818:Practice Patterns, Physicians' / Q000592:standards*; D013597:Systems Analysis; D014481:United States