Dr Brand's letter lays many of the real and perceived deficits of the modern medical scene at the door of professionalism, either in terms of responsibility for their existence or failure to move appropriately to correct them. Many of the problems she notes, whatever their ultimate causes, are real enough: collaborations could be stronger; technical language tends to interfere with doctor-patient communication; we could do a lot better with regard to affirmative action in recruiting to medical careers; and efforts to engage productively with the policy community have been irregular and ineffective. On the other hand, many would take issue with parts of her indictment, including the implication that professionalism implies elitism, a stance of aloofness from the sick, arrogance, and inhibition of efforts to enhance quality in medical care.
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