Physician views on practicing professionalism in the corporate age

Arnold Relman argues that medical education does not prepare students and r esidents to practice their profession in today's corporate health care syst em. Corporate health care administrators agree: Physicians enter the workfo rce unskilled in contract negotiation, evidence-based medicine, navigating bureaucratic systems, and so forth. What about practicing physicians? Do th ey agree as well? According to this study, they do. Feeling like decentered double agents and unprepared, physicians find themselves professionally lo st, struggling to balance issues of cost and care and expressing lots of ne gativity toward the cultures of medicine and managed care. However, physici ans are resilient. A group of physicians, who may be called proactive, are meeting the professional demands of corporate health care by becoming sophi sticated about its bureaucratic organization and the ways in which their pr ofessional and personal commitments fit within the system. Following the le ad of proactive physicians, the auf hors support Relman's thesis that educa tion for both students and physicians requires a major overhaul.