To the Editor: Your enthusiastic comments accompanying the publication of a "physicians' charter" prepared by the Medical Professionalism Project1 do not acknowledge strikingly enhanced approaches to medical professionalism in Australia dating from the landmark Doherty Report in 1988.2 One of the most noticeable changes since that time is the emphasis now placed on professional development throughout medical school curricula3 and in the preregistration year.4,5 In addition, our medical colleges are poised to do more in this area in their postgraduate training and continuing professional development programs.6 You fail to point out that the "physicians' charter" contains nothing new, as an examination of the Code of Ethics of the Australian Medical Association will reveal.7

We are probably fortunate that an equivalent process of developing such a charter has not taken place in Australia. The document repeatedly speaks of a "contract with society", but it is an oddly one-sided contract, prepared without consulting members of the communities the authors purport to represent. The charter seems to be a response to frustrations and challenges caused by changes to healthcare systems, especially in the United States and Canada, and carries a tone of living in the past.

There are effective means of engaging with our community to ensure that essential aspects of medical professionalism are valued and maintained.8 Many of these are already being used in Australia. I refer to such developments as community membership of medical boards, community input into selection of medical students, establishment of independent health complaints commissions and widespread engagement with the health consumer bodies by most sections of the profession. Additional initiatives that will assist the community to trust and value medical professionalism in Australia include the increased expectation that all doctors will engage in continuing medical education and the establishment by medical boards of pathways to identify and assist poorly performing doctors.

Should the organised profession ever develop a similar charter for Australia, it is to be hoped that the authors will ensure that the concerns and needs of our broader community are taken into account and that we do not engage in the self-pity evident in the Medical Professionalism Project.