Professionalism in the 21st century

Abstract

During the last few years, health care in Malta has under gone numerous important changes. The Health Care Professions Act 2003 1 has redefined the relationship between the different professions in the health care sector, with the Specialists Accreditation Committee (SAC) and the numerous medical specialists associations and colleges being recognised as the regulators of the different specialities. Faced with today's many changes and challenges it is wrong to assume that all doctors understand what it means to be a professional and use this understanding as they make decisions in their private and professional lives. Confronted with reformation of the Maltese health care system, it is opportune for every medical practitioner to think and reflect on what professionalism means, as the traditional understanding of professionalism is not adequate any longer. In the international literature, much attention has been devoted in the last decade to the question of professionalism in medical education and medical practice. 2 - 9 Because the word professionalism carries with it 50 many connotations, and complexities, there is no common understanding of what is meant by professionalism. In times when few people had the opportunity to get an education, the term "profession" meant one of the "classical professions": medicine, law, or theology. Today there are hundreds of disciplines and occupations whose educational, scientific, and academic rigor have grown up to be equal to that of classical professions, and as such they call themselves professions. Different occupational groups have used the word differently and for different purposes. Unfortunately, the designation has always been a starus symbol, sought by many and achieved by few. Accountants, engineers, architects, pharmacists, nurses and social workers are among those who have earned it and the)' are issued a licence by the President of Malta authorizing them to practice independently. Optometrists, dieticians and therapists are among those who are pressing hard to get full recognition, but are still considered by law as "professions complementary to medicine".l Furthermore, at a time when "rat catchers" are "rodent operatives" and "trash collectors" me "waste disposal executives," and when the prevailing view is that "we're all professionals now", the exact meaning and significance of professionalism is uncertain; it has virtually lost its meaning because it is 50 widely used. Yet if professionalism is to remain integral to medical education and medical practice, and if professionalism is to result in meaningful change that benefits both the medical profession and the society it serves, it is necessary that 14 VOLUME 15 ISSUE 01 JUNE 2006 every doctor has a clear understanding of what medical professionalism entails.