To understand professionalism, it is necessary to understand the nature of a profession. The medical community seems almost intuitively to grasp what the word profession means when applied to medicine, but it is important also to have a more structured understanding about what a profession is. Profession serve as guardians of social values and professionals are expected to articulate and hold those values publicly1. A profession, then, becomes a way of life with a moral value. It is in this sense that a profession becomes a calling, not simply an occupation.
Professions always reflect the particular social and cultural milieus in which they operate. Rapid advances of knowledge during the past 30-40 years have changed the natures of all professions, but none more dramatically than medicine. Professions have become more closely connected to eth application of expert knowledge and less closely linked to functions central to the good of the public they serve. The rise of this expert professionalism has paralleled a decline in the older sense of social-trustee professionalism2. The control and application of a specialized body of knowledge has come more and more to characterize a profession, as knowledge in all fields has grown and become more complex. But to rely solely on expertise is to diminish the special nature of a profession, especially in so far as it addresses society’s needs. Stevan Brint argues that without a strong sense of the public and social purposes served by professional knowledge, professionals tend to lose their distinctive voice in public debate2. In many ways, that is the position in which the profession of medicine now finds itself: it has become distracted from its public and social purposes and thus lost its distinctive voice. In recent years, the debate about health care has been dominated not by physicians, individually or collectively, but by business, economic, and political interest. Strengthening medical professionalism becomes one way to restore medicine’s distinctive voice.
In this article, I offer a new point of view and a new way to frame considerations of medical professionalism.