Restoring medical professionalism.

The essence of medical professionalism is placing dedication to the welfare of patients above physicians' personal or proprietary interests. Medicine has become deprofessionalized as a consequence of socioeconomic factors leading to increasing commercialization and perverse financial incentives converting it into a business, the presence of unmanaged conflicts of interest, challenges to medical authority by insurance companies and the consumerism movement, and by gradual changes in the attitudes of physicians. Organized medicine has responded by making explicit its standards of professionalism and its dedication to preserving them. Medical educators have studied the means to develop professional attitudes and behaviors among medical students and residents. Modeling the characteristics of professional behavior by virtuous physicians remains the most effective method to instill professional behaviors in trainees. Restoring professionalism may be abetted by changes in physicians' financial incentives through innovative models of health care delivery, by physicians reducing their conflicts of interest, and by medical societies rejecting a guild identity.