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Internal Medicine Groups Unveil New Charter on Medical Professionalism

PHILADELPHIA -- Three influential organizations of internal medicine physicians have unveiled a new charter on medical professionalism. The charter, consisting of three fundamental principles and 10 definitive professional responsibilities, is published in the February 5, 2002, issue of Annals of Internal Medicine and February 9 issue of The Lancet.

The American Board of Internal Medicine (ABIM), American College of Physicians-American Society of Internal Medicine (ACP-ASIM), and the European Federation of Internal Medicine (EFIM) say that the volatile health care environment -- hit by the explosion of technology, changing market forces, problems in health care delivery, and globalization -- is affecting the practice of medicine. The organizations ask all physicians to reaffirm their professional commitments to their patients and the public.

The three principles underpinning the practice of medicine, the organizations say, are the primacy of patient welfare, patient autonomy and social justice. From these principles stem a list of ten responsibilities that are both individual and collective obligations for physicians.

According to the charter, physician obligations include commitment to:

  1. professional competence;
  2. honesty with patients;
  3. patient confidentiality;
  4. maintaining appropriate relations with patients;
  5. improving quality of care;
  6. improving access to care;
  7. a just distribution of finite resources;
  8. scientific knowledge;
  9. maintaining trust by managing conflicts of interest, and
  10. professional responsibilities, such as regulating members and setting standards.

The charter was written by members of the Medical Professionalism Project sponsored by the ABIM Foundation, the ACP-ASIM Foundation and the EFIM. Members of the projects working committee met over an 18 month period to develop and refine the charter. They recognized differences in the practice of medicine among diverse cultures and national traditions and uneven distribution of health care resources worldwide but said that the charter is not limited to Western medicine. The charter is intended to "promote an action agenda for the profession of medicine that is universal in scope and purpose."

Medical Professionalism Project members comment on the charter:

Walter McDonald, MD Executive Vice President and CEO, American College of Physicians-American Society of Internal Medicine
"The charter is a call to individual physicians to reaffirm their dedication to the welfare of their patients and to the profession to collectively work to improve health care for all."

Troy Brennan, MD, Chair, Medical Professionalism Project
"The Charter incorporates our traditional understanding of professional norms into the circumstances of the practice of medicine today, and is intended to provide guidance to physicians faced with a variety of new ethical challenges."

Harry Kimball, MD, President, ABIM Foundation
"We envision the charter as a conduit to strengthen public trust by reaffirming professional values."

Christopher Davidson, MD, Secretary General, European Federation of Internal Medicine
"The European Federation of Internal Medicine sees the Charter as a milestone in improving the patient-physician relationship. We are dedicated to implementing it across the continent as a set of professional values that empower both doctor and patient in the 21st Century."

Jordan Cohen, MD, President, Association of American Medical Colleges
"The professionalism charter offers an opportunity for physicians everywhere to reaffirm their commitment to the fundamental virtues of their calling."

Neil Smelser, PhD, University Professor Emeritus, University of California, Berkeley
"The charter is a genuine breakthrough. It achieves, for the first time, a statement of truly transnational principles of the professional and ethical aspects of medicine. It states these principles crisply and authoritatively. Most impressively, it cuts through the brambles of revolutionary change in the technological and social contexts of medicine and identifies the abiding universals."

The Editor of Annals of Internal Medicine comments on the importance of the charter.

Harold Sox, MD, editor of Annals of Internal Medicine, prefaces the charter, saying, "Forces that are largely beyond our control have brought us to circumstances that require a restatement of professional responsibilities. The challenge will be to live by these precepts and to resist efforts to impose a corporate mentality on a profession of service to others."

More information about the Medical Professionalism Project is available at www.professionalism.org. The charter is posted on the Web site of Annals of Internal Medicine (www.annals.org) and The Lancet (www.thelancet.com).

To contact Walter McDonald, MD, executive vice president and CEO, ACP-ASIM, and Harold Sox, MD, Editor, Annals of Internal Medicine, please call ACP-ASIM Communications Department (215-351-2653).

To contact Troy Brennan, MD, chair, Medical Professionalism Project, please call 617-732-8961.

To contact the ABIM Foundation, please call Linda Blank, senior vice president, 215-446-3567.

The American Board of Internal Medicine, founded in 1936, is the only recognized board in the specialty of internal medicine in the United States and is one of the 24 certifying boards of the American Board of Medical Specialties. ABIM is an independent, non-profit organization whose certificate is recognized throughout the world as signifying a high level of physician competence. The Board receives no public funds and does not issue licenses.

The American College of Physicians-American Society of Internal Medicine, founded in 1915, is the largest medical specialty organization in the United States and the second-largest physician group. Its membership comprises more than 115,000 internal medicine physicians and medical students. ACP-ASIM publishes Annals of Internal Medicine and other medical publications. Internists are doctors for adults who provide comprehensive diagnostic and preventive specialty care.

The European Federation of Internal Medicine, founded in 1996 from the European Association of Internal Medicine, is a scientific organization that holds a scientific congress every two years and publishes the European Journal of Internal Medicine. The federation, which currently has 27 member societies, brings together European national societies of internal medicine. Its purpose is to re-emphasize the importance of internal medicine in patient care in a world of increasing specialization.

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