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Physician professionalism is the essence of being a doctor in our society. Physicians have a social agreement with society to act as a fiduciary in the patient-physician relationship. The introduction of managed medicine and the altered medical landscape has caused a disruption to that contract. The medical profession is being challenged by an eruption of technology, fluctuating market forces, and problems in the ever-changing landscape of healthcare delivery. Steadily increasing transformations across an array of technology and market changes make it a real undertaking for physicians to meet their obligations to patients. Indeed, the medical profession must contend with political, legal, and market forces that challenge physicians to meet their ethical responsibilities to their patients. We address the challenges physicians face and the duties they have to understand to maintain their professionalism.
KEY WORDS: Fiduciary; physician professionalism; confidentiality clauses; incentive clauses; referral restrictions; "gag" clauses.
Professionalism is the basis of medicine's social agreement with society. The contractual relationship between physicians and society demands that the interests of patients be placed above those of treating physicians. It also obliges physicians to set and maintain standards of competence and integrity and to provide knowledgeable and professional advice to society on matters of health and well-being.1 Physicians must act as a fiduciary to the patient, which means they must place the interests of their patients above all competing interests.
The medical profession is being challenged to meet its fiduciary responsibilities by an eruption in technology, fluctuating market forces, and evolving duties in the everchanging healthcare delivery system. The exponential transformations across an array of technology and market changes make it a real challenge for physicians to meet their obligations to patients. Indeed, the medical profession is confronted with political, legal, and market forces that challenge physicians to meet their fiduciary responsibility to their patients.
The fundamental principles inherent to physician professionalism include patient welfare; patient autonomy; and elimination of discrimination in healthcare, whether based on race, gender, socioeconomic status, ethnicity, or religion. Market forces, societal pressures, and administrative exigencies must not compromise the principles inherent in a true physician-patient relationship. Physicians must be sincere and trustworthy with patients and empower them to make informed decisions about their treatment options. Patients' decisions about their medical care must be...