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  • Patient Welfare

  • Patient Autonomy

  • Social Justice

  • Professional Competence

  • Honesty with Patients

  • Patient Confidentiality

  • Appropriate Relations with Patients

  • Just Distribution of Finite Resources

Over the last three decades, there has been an emphasis on the understanding and teaching of professionalism in both practice and education. Accrediting bodies such as the Liaison Committee on Medical Education (LCME) and Accreditation Council for Graduate Medical Education (ACGME) have expectations that trainees in medical school and residency programs will have training in medical professionalism.

Medical specialty organizations have issued statements and position papers with the expectation that practicing physicians and educators will uphold and teach the tenets of professionalism. The Physician Charter is the most cited example, having been endorsed by over 100 medical organizations. In the charter (see Table 2-1), there are three fundamental principles and ten professional responsibilities that comprise the elements of medical professionalism.

Table 2-1The Physician Charter

The American College of Physicians periodically publishes an updated Ethics Manual—the seventh edition was published in 2019. The updates include new or expanded topics to address changes in technology and the practice of medicine such as telemedicine ethics, electronic health records, and precision medicine and genetics.

The following eight sections illustrate excerpts from the Physician Charter along with related challenges that physicians may have while trying to adhere to the charter’s principles.

Original chapter by John Spandorfer, MD


The principle of patient welfare is based on a dedication to serving the interest of the patient. Altruism contributes to the trust that is central to the physician–patient relationship. Market forces, societal pressures, and administrative exigencies must not compromise this principle.

While recognizing the need to serve the interests of their patients, physicians also need to be aware of their own well-being and balance how to prioritize patient care while avoiding burnout. Physicians should become adept at collaborating with other members of the healthcare team to maximize efficient and effective care. This collaboration with other healthcare workers helps to ease the burden on any individual physician while ensuring the needs of the patient are met.


Physicians must have respect for patient autonomy. Physicians ...

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