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Lecturer defines ‘new professionalism’The practice of medicine will be different than it is today, and not as vibrant,” if physicians succumb to the financial pressure that faces them, Troyen A. Brennan, M.D., J.D., M.P.H., told students at the Case Western Reserve University School of Medicine in the third annual Professionalism Lecture, March 9 in the university’s Strosacker Auditorium. In his talk, titled “Medical Professionalism in 21st-Century American Health Care,” Dr. Brennan warned students that the delivery of health care could become stratified if physicians do not take action soon. A professor of medicine at Harvard Medical School, a professor of law and public health at the Harvard School of Public Health, and president of the Brigham and Women’s Physicians’ Organization, he told the students that, upon graduation, they will face an aging population and shrinking financial base supporting medical care. The future of medicine looks bleak, he said, “unless we as a profession show more high-mindedness and a sense of duty, not only to our individual patients but also to a whole class of patients.” Such high-mindedness includes a rethinking of what it means to be a professional, Dr. Brennan said, so that each physician views as his or her responsibility the goals of improving quality, ensuring access and reducing costs associated with health care. Improving the quality of care and access to care are not necessarily considered part of professionalism as it is traditionally defined, he added. Dr. Brennan chaired the American Board of Internal Medicine Foundation/American College of Physicians—American Society of Internal Medicine Foundation/European Society for Internal Medicine Medical Professionalism Project in 2000. Elaborating on the outcome of that experience, he said that the “new professionalism” views medicine as a vocation, not a job; holds that the system of care is as much a responsibility as is the care of the individual patient; and is one in which physicians act as a collective, which requires leadership. The next 15 to 20 years “is going to be a critical time,” he told the students. “You’re going to have to be leaders.” Otherwise, he said, medicine will be ruled by the market economy and controlled by outside forces. The Professionalism Lecture, initiated by Case medical students through the student affairs committee of the school’s Medical Alumni Association and the Committee of Student Representatives, is the only event simultaneously attended by all medical school classes.
—Lois A. Bowers |
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