Managed care and the imperative for a new professional ethic.

Physicians complain about the growth of managed care structures and strategies and their effects on treatment autonomy and medical professionalism. Organizational changes and a competitive marketplace make the traditional view less relevant today. New concepts of professionalism are needed that recognize constraints and include patient advocacy within a framework of procedural justice, responsibility for population health, new patient partnerships, and participation in an evidence-based culture. Such changes require more focused efforts in medical education to support the new professionalism.