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      Transforming medical professionalism to fit changing health needs

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      1 , , 1 , 2
      BMC Medicine
      BioMed Central

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          Abstract

          Background

          The professional organization of medical work no longer reflects the changing health needs caused by the growing number of complex and chronically ill patients. Key stakeholders enforce coordination and remove power from the medical professions in order allow for these changes. However, it may also be necessary to initiate basic changes to way in which the medical professionals work in order to adapt to the changing health needs.

          Discussion

          Medical leaders, supported by health policy makers, can consciously activate the self-regulatory capacity of medical professionalism in order to transform the medical profession and the related professional processes of care so that it can adapt to the changing health needs. In doing so, they would open up additional routes to the improvement of the health services system and to health improvement. This involves three consecutive steps: (1) defining and categorizing the health needs of the population; (2) reorganizing the specialty domains around the needs of population groups; (3) reorganizing the specialty domains by eliminating work that could be done by less educated personnel or by the patients themselves. We suggest seven strategies that are required in order to achieve this transformation.

          Summary

          Changing medical professionalism to fit the changing health needs will not be easy. It will need strong leadership. But, if the medical world does not embark on this endeavour, good doctoring will become merely a bureaucratic and/or marketing exercise that obscures the ultimate goal of medicine which is to optimize the health of both individuals and the entire population.

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          Most cited references47

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          The epidemiologic transition: a theory of the epidemiology of population change. 1971.

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            The Limits of Reductionism in Medicine: Could Systems Biology Offer an Alternative?

            In the first of a two part series, Ahn and colleagues discuss the reductionist approach pervading medicine and explain how a systems approach (as advocated by systems biology) may complement reductionism.
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              A conceptual framework for the OECD Health Care Quality Indicators Project.

              The Health Care Quality Indicator (HCQI) Project of the Organization for Economic Cooperation and Development (OECD), which is aimed at developing a set of indicators for comparing the quality of health care across OECD member countries, requires a balanced conceptual framework that outlines the main concepts and domains of performance that should be captured for the current and subsequent phases of the project. This article develops a conceptual framework for the OECD's HCQI Project. It first argues that developing such a framework should start by addressing the question, 'performance of what-and to what ends?' We identify at least two different major classes of frameworks: (i) health and (ii) health care performance frameworks, both of which are in common use. For the HCQI, we suggest a conceptual framework that is largely a purposeful modification of the existing performance frameworks and which is driven by the health determinants model. The conceptual basis for performance frameworks can be traced back to the health determinants model. A health performance framework takes a broader, societal or public health view of health determination, whereas a health care performance takes a narrower, mostly clinical or technical view of health care in relation to health (needs). This article proposes an HCQI framework that focuses on the quality of health care, maintains a broader perspective on health and its other determinants, and recognizes the key aims of health policy.
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                Author and article information

                Journal
                BMC Med
                BMC Medicine
                BioMed Central
                1741-7015
                2009
                26 October 2009
                : 7
                : 64
                Affiliations
                [1 ]Department of Social Medicine, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
                [2 ]Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD 21205, USA
                Article
                1741-7015-7-64
                10.1186/1741-7015-7-64
                2773806
                19857246
                3278f464-483e-4858-b23f-bd1000f3334a
                Copyright © 2009 Plochg et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 3 July 2009
                : 26 October 2009
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                Medicine
                Medicine

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