A profession is defined as an occupation founded upon specialized educational training, the purpose of which is to supply disinterested, objective counsel and service to others for direct and definite compensation. The two key components of this very “matter of fact” definition are specialized educational training and offering a service to others for payment. Unquestionably, those that provide medical care do fall within this definition. However, a necessary component of professionalism is self-regulation. If self-regulation isn’t apparent, a profession runs the risk of falling into disarray with the potential of self-interest, outweighing the services to others because of the level of compensation, and thus, the focus turns more to financial gain.
The medical profession is self-governed through a myriad of national organizations that are responsible for accreditation, assessment, licensure in coordination with states, and certification. Furthermore, specialty societies exist with a deep connection to its members’ stipulating clinical care standards. Additionally, Medical associations promote the representation of practicing physicians.
Unfortunately, although all serving an important role in governing their specific part of medical care, these communities don’t work in unison, nor do they always profess that service to others is their guiding principle. Which is why I am discussing the purpose of self-regulation. If we are to operate at the highest level of our profession, it is paramount to promote excellent care delivered by those trained appropriately and that we self-police for inappropriate care and behaviors.
You may remember, the rights of states to regulate medicine became a reality with the passage of the 10th Amendment to the Constitution, which expresses a fundamental principle of federalism that empowers state governments to act in the best interest of its citizens concerning health, safety, and welfare of the public.
Without all these organizations mentioned above working in tandem, agendas compete, potentially leading to a divide in our professional goals. If we aspire to continue our noble profession, we must act as one. In this day of communication and technology, do we need to move to a different licensing model that does not stop at the state border? Do we need to embrace new adult learning models and continuous improvement? Since those we serve desire greater transparency and shared decision-making, do we need to elevate our peer review to a level that encompasses those we serve in a revitalized manner?
Self-regulation is an earned privilege we must take seriously. If we do not, others will fill the gap left by our inability. And, undoubtedly external regulation seeks to occur in higher degrees as there will be an outcry to protect the public. It is my belief that meritocracy models of regulation will always produce more significant results than external oversight.
The same is valid for medical care. How do we act as one when our, various clinical societies do not agree on treatment protocols? This conundrum creates confusion and the inability for us to provide evidence-based care as we are left with a myriad of choices. With these externalities affecting who we are and what we do, we run the risk of medicine becoming a commodity. Let us embrace these issues of professionalism and remember our calling, to serve others. Coordination and consolidation of all our diverse organizations needs to occur. Building on a foundation of mutual respect, trust, and purpose will allow us to come together in a way that will elevate our profession.