Professionalism in Tomorrow's

Healthcare System

Towards Fulfilling the ACGME Requirements

for Systems-Based Practice and Professionalism

Edited by Ann E. Mills, Donna T. Chen, Patricia H. Werhane, and Matthew K. Wynia

2005. 276 pages. ISBN 1-55572-037-4.

$34.99 plus $4.75 S&H. Please ask about instructors' discounts.

How should physicians be trained to deal with the complexities

of our changing healthcare system? The Outcome Project of the

Accreditation Council for Graduate Medical Education (ACGME)

identifies six competencies in residency training — and the types

of expertise and obligations each requires.

This book critically discusses two of the competencies:

a systems-based practice competency and a competency on professionalism.

These two competencies suggest that “professionalism” is undergoing

radical change, in which residents must commit to “ethical principles

pertaining to business practices.” What will these changes mean for

physicians, their patients, and society?

In response, the contributors challenge us to revisit our understanding

— and assumptions — of physician professionalism. This book is

for medical educators, physicians, administrators, residents,

and anyone interested in how physicians are being trained for the future.
 

Drawing on experiences from daily practice, current literature,

and insights gained from the Relational Ethics Research Program,

the authors invite readers to reflect on the many ways that relationships

influence ethical actions—and outcomes—and how they can be improved.

Donna T. Chen, MD, MPH, is an Assistant Professor of Public Health Sciences,

Psychiatric Medicine, and Biomedical Ethics and Coordinator of Professionalism Education

for the Center for Biomedical Ethics at the University of Virginia in Charlottesville. 
Ann E. Mills, Msc (Econ), MBA, is an Assistant Professor in the Center for Biomedical Ethics

at the University of Virginia in Charlottesville.
Patricia H. Werhane, PhD, has a joint appointment as Wicklander Chair of Business Ethics

and Director of the Institute for Business and Professional Ethics at DePaul University

in Chicago and as Ruffin Professor of Business Ethics and Senior Fellow of the Olsson Center

for Applied Ethics, Darden Graduate School of Business Administration, University of Virginia,

Charlottesville.
Matthew K. Wynia, MD, MPH, is Director of the Institute for Ethics at the American Medical

Association.

CONTENTS
 

Introduction
       Ann E. Mills, Donna T. Chen, Patricia H. Werhane, and Matthew K. Wynia
Professionalism
1.    Towards a New Concept of Professionalism: Being a Physician in Today’s

       Healthcare System
       Edward M. Spencer and Rebecca Bigoney
2.    Towards Systems-Informed Professionalism
       Donna T. Chen, Ann E. Mills, and Patricia H. Werhane
3.    The Ethical Climate: Can Organizational Ethics Programs Influence

       Management Initiatives?
       Paul A. Clark
The Financial Perspective
4.    Professionalism in Medicine and in Business
       Lisa H. Newton
5.    The Clinical Health Economics System Simulation (CHESS):

       A New Tool for Promoting Competency in Systems-Based Practice

       and Professionalism
       John D. Voss, Natalie B. May, and Joel M. Schectman

Internal Patient Care and Business Processes
6.    Business Practices, Ethical Principles, and Professionalism
       Ann E. Mills and Mary V. Rorty
7.    Individuals, Systems, and Professional Behavior
       Evan G. DeRenzo
Learning and Growth
8.    Professionalism, Humanism, Mindfulness, and the Healthcare Melee
       Daniel M. Becker and Matthew J. Goodman
The Patient’s Perspective
9.    Through the Looking Glass: The Patient’s Point of View
       Daniel M. Becker

Residency Training and Outcomes Assessment
10.   Educating for Systems-Informed Professionalism
       Donna T. Chen and Ann E. Mills
11.   The Challenges of a Residency Education Program for Competencies in

       Organizational Ethics
       David T. Ozar
12.   The Patient’s Perspective in the ACGME Systems-Based Competency
        Walter S. Davis
13.   Training Residents for Excellence in Systems-Based Clinical Practices:

        Management of Blood Draws as the Quintessential Outcome Measure
        Evan G. DeRenzo, Phil Buescher, and Kirsten Alcorn
Summary and Conclusion
        Ann E. Mills, Donna T. Chen, Patricia H. Werhane, and Matthew K. Wynia
Appendix: The ACGME Outcome Project General Competencies