The Charter on Professionalism for Health Care Organizations.

In 2002, the Physician Charter on Medical Professionalism was published to provide physicians with guidance for decision making in a rapidly changing environment. Feedback from physicians indicated that they were unable to fully live up to the principles in the 2002 charter partly because of their employing or affiliated health care organizations. A multistakeholder group has developed a Charter on Professionalism for Health Care Organizations, which may provide more guidance than charters for individual disciplines, given the current structure of health care delivery systems.This article contains the Charter on Professionalism for Health Care Organizations, as well as the process and rationale for its development. For hospitals and hospital systems to effectively care for patients, maintain a healthy workforce, and improve the health of populations, they must attend to the four domains addressed by the Charter: patient partnerships, organizational culture, community partnerships, and operations and business practices. Impacting the social determinants of health will require collaboration among health care organizations, government, and communities.Transitioning to the model hospital described by the Charter will challenge historical roles and assumptions of both its leadership and staff. While the Charter is aspirational, it also outlines specific institutional behaviors that will benefit both patients and workers. Lastly, this article considers obstacles to implementing the Charter and explores avenues to facilitate its dissemination.

Professional medical associations and their relationships with industry: a proposal for controlling conflict of interest.

Professional medical associations (PMAs) play an essential role in defining and advancing health care standards. Their conferences, continuing medical education courses, practice guidelines, definitions of ethical norms, and public advocacy positions carry great weight with physicians and the public. Because many PMAs receive extensive funding from pharmaceutical and device companies, it is crucial that their guidelines manage both real and perceived conflict of interests. Any threat to the integrity of PMAs must be thoroughly and effectively resolved. Current PMA policies, however, are not uniform and often lack stringency. To address this situation, the authors first identified and analyzed conflicts of interest that may affect the activities, leadership, and members of PMAs. The authors then went on to formulate guidelines, both short-term and long-term, to prevent the appearance or reality of undue industry influence. The recommendations are rigorous and would require many PMAs to transform their mode of operation and perhaps, to forgo valuable activities. To maintain integrity, sacrifice may be required. Nevertheless, these changes are in the best interest of the PMAs, the profession, their members, and the larger society.

Council ofMedical Specialty Societies: committed to continuing medical education reform.

The Council of Medical Specialty Societies (CMSS) recognizes the need for continuing medical education (CME) reform and intends to be actively engaged in that process. While recognizing that CME reform must involve many organizations, the CMSS and particularly the 23 societies that make up the CMSS are in a position to affect many of the needed changes. Of these, perhaps the most important is the need to link CME to a change in physician behavior and patient outcomes. Other important tasks involve the expansion and improvement of available needs assessment modalities, the development and updating of curricula, the official recognition of multiple modalities available for physician learning, the broadening of the CME research agenda, and the need to explore alternate ways of financing lifelong learning. With the accomplishment of these reforms, medical education may finally be viewed as a continuum from undergraduate education through education of the practicing physician, and patient safety will be favorably impacted. Education will change from an episodic experience to a continuous process and one that is based on the realities of practice. These reforms will take time to accomplish and to be accepted by a profession that currently views itself as besieged by regulatory agencies and without the time and resources needed to comply with the changes.