Physician views on practicing professionalism in the corporate age. Qualitative Health Research

Arnold Relman argues that medical education does not prepare students and residents to practice their profession in today’s corporate health care system. Corporate health care administrators agree: Physicians enter the workforce unskilled in contract negotiation, evi-dence-based medicine, navigating bureaucratic systems, and so forth. What about practic-ing physicians? Do they agree as well? According to this study, they do. Feeling like decentered double agents and unprepared, physicians find themselves professionally lost, struggling to balance issues of cost and care and expressing lots of negativity toward the cul-tures of medicine and managed care. However, physicians are resilient. A group of physi-cians, who may be called proactive, are meeting the professional demands of corporate health care by becoming sophisticated about its bureaucratic organization and the ways in which their professional and personal commitments fit within the system. Following the lead of proactive physicians, the authors support Relman’s thesis that education for both students and physicians requires a major overhaul. In a 1998 essay in Academic Medicine, Arnold Relman—editor-in-chief emeritus ofThe New England Journal of Medicine and major advocate for advancing profes-sionalism—argues that medical education in the United States is not equipping physicians with the tools necessary to practice their profession in today’s changin