Promoting professionalism through humanities-based transformation.

In the last two decades, academic medical centers in the United States have faced a new challenge, dealing with breaches of medical professionalism in their staff, house staff, and medical students. Medical education settings have largely directed their professionalism efforts toward responding reactively to negative outliers. This paper contends that the warrant of medical education mandates a transformative path forward. While negative behavior must be responded to meaningfully, so, too, must positive role models of professional behavior be publicly lauded for their consequential culture change in their institutions, and promoted as positive role models. Further, the promotion of medical professionalism must be part of this culture by proactively engaging all learners and health care providers with medical ethics and humanities-based knowledge, critical thinking skills, and role modeling. Professionalism programs should be vested with the authority to implement an affirmative educational program intended to nurture and promote medical professionalism in each medical student, resident, fellow, and attending and utilize methods to that end employing both virtue and care ethics. Medical professionalism is the foundational concept grounded upon scientific- and humanities-based knowledge and skills, directed toward the promotion of patient benefit with the rejection of self-interest, delivered with excellence in comportment, and the adherence to a covenant of trust with society.Medical educators who solely emphasize the detection and punishment of negative outliers are missing essential elements in promoting medical professionalism.Medical professionalism should be comprehensively addressed through a systematic addressing of teaching fundamental knowledge, skills, and virtue, promote excellence in role modeling and mentorship, and the redress of those lacking insight in their professional conduct.