New Study Finds Health Care Organizations Share a Common Strategy to Advance Medical Professionalism

(Philadelphia, PA) Most health care organizations share a common strategy in articulating and reinforcing the professional values of physicians, even if they talk about it in different ways, according to a new study published in BMJ Quality and Safety.

Researchers from American Board of Internal Medicine and ABIM Foundation interviewed leaders from 30 health care organizations across the country to better understand how they advance professional behaviors amongst physicians. The study – "Organizational Strategies to Cultivate Professionals Values and Behaviors" – found three key themes that health care organizations use to drive professionalism:

- First, leaders articulated values and drew a clear link between these values and expected behaviors.
- Second, leaders emphasized aligning organizational systems and structures to support desired behaviors.
- Third, leaders believed that cultivating strong interpersonal relationships within their organizations was key to disseminating and reinforcing organizational values and behaviors.

The researchers used the principles and commitments of Medical Professionalism in the New Millennium: A Physician Charter as a framework for defining professionalism. Authored by the ABIM Foundation in 2002, in partnership with the American College of Physicians Foundation and the European Federation of Internal Medicine, the Charter articulates professional responsibilities of physicians, including a commitment to improving quality and access to care, advocating for a just and cost-effective distribution of finite resources and maintaining trust by managing conflicts of interest.

The researchers found that, while leaders used different words or phrases to define professionalism, each organization "… went beyond the presence of a written mission or values statement and used values as a framework for a number of organizational systems and structures that support professional behaviors."

"The environment physicians practice in has a direct influence on their professional behavior," said Christine Cassel, MD, President and CEO of the American Board of Internal Medicine and ABIM Foundation. "By clearly articulating the organization's values and behavioral expectations, providing structural supports and cultivating strong relationships, health care leaders can create a culture based on professionalism within their organizations."

A 2007 study published in Annals of Internal Medicine, "Professionalism in Medicine: Results of a National Survey of Physicians" reported similar findings. Researchers found that while most physicians support the ideals of professionalism, their behavior did not always reflect their beliefs. The authors wrote that "…structural factors of the U.S. health care system probably exert independent effects on the professional activities and attitudes of physicians."

The authors of "Organizational Strategies to Cultivate Professionals Values and Behaviors" emphasize that in advancing professionalism leaders need to view health care organizations as complex adaptive systems and recognize "…there are no 'one-size-fits-all' solutions for promoting values and behaviors; rather, each organization will need to consider its own needs and context."

To stimulate conversation and highlight best practices to advance professionalism, the ABIM Foundation recently launched "The Medical Professionalism Blog". The blog features new research, innovative ideas and thought-provoking commentaries to engage stakeholders in advancing medical professionalism, improving quality of care and reducing unnecessary waste in the health care system.

"Organizational Strategies to Cultivate Professionals Values and Behaviors" was authored by current and former staff of the American Board of Internal Medicine and the ABIM Foundation:

- Amy T. Cunningham, MPH, Program Administrator/Analyst, ABIM Foundation;
- Elizabeth C. Bernabeo, MPH, Research Associate, American Board of Internal Medicine;
- Daniel Wolfson, MHSA, Executive Vice President and COO, ABIM Foundation; and
- Cara S. Lesser, MPP, Director of Foundation Programs, ABIM Foundation (former); Deputy Director, Office of Planning and Evaluation, Office of Consumer Information and Insurance Oversight, U.S. Department of Health and Human Services (current).

About the ABIM Foundation
The mission of the ABIM Foundation is to advance medical professionalism to improve the health care system. We achieve this by collaborating with physicians and physician leaders, medical trainees, health care delivery systems, payers, policy makers, consumer organizations and patients to foster a shared understanding of professionalism and how they can adopt the tenets of professionalism in practice. To learn more about the ABIM Foundation, visit www.abimfoundation.org, connect with us on Facebook or follow us on Twitter.