Managed care and the imperative for a new professional ethic

Physicians complain about the growth of managed care structures and strateg ies and their effects on treatment autonomy and medical professionalism. Or ganizational changes and a competitive marketplace make the traditional vie w less relevant today. New concepts of professionalism are needed that reco gnize constraints and include patient advocacy within a framework of proced ural justice, responsibility for population health, new patient partnership s, and participation in an evidence-based culture. Such changes require mor e focused efforts in medical education to support the new professionalism.